The results of radial artery Y-graft for complete arterial revascularization

Yilmaz, Ahmet Turan; Ozal, Ertugrul; Barındık, Nadir; Günay, Celalettin; Tatar, Harun
May 2002
European Journal of Cardio-Thoracic Surgery;May2002, Vol. 21 Issue 5, p794
Academic Journal
Objective: Harvesting of multiple arterial grafts is commonly associated with prolonged operating times and increased trauma in complete arterial coronary artery bypass grafting (CABG). Using sequential grafting techniques, CABG is possible with only two arterial grafts in multi-vessel coronary artery disease (CAD). However, sequential grafting may not be convenient for all circumstances and sometimes surgical technique may be challenging. We present our experience in the use of radial artery (RA) Y-graft on a routine basis. Methods: Between January 1996 and November 2001, 127 patients (aged 63±8 years) with the diagnosis of multi-vessel disease underwent complete arterial revascularization using left internal mammarian artery (LIMA) and RA. Left ventricular ejection fraction ranged from 23 to 65% (mean 51±11%). Triple-vessel disease was present in 73.2% of patients. We used the division technique of RA during harvesting and formation of one or more composite Y-grafts of the RA itself to allow end-side rather than sequential anastomoses without any significant decrease the usable conduit length. The results of this technique were compared with the data of patients (n=109) who underwent completely arterial CABG with the use of the multiple arterial grafts in the same period. Results: LIMA was anastomosed to the left anterior descending coronary artery (LAD) system in all patients. Two to four (mean 2.8±0.6) anastomoses were performed with RA Y-graft per patient. Proximal end of the radial graft was anastomosed to LIMA (60.6%) or aorta (39.4%). Mean operating time was 185 (45 min; bypass time, 68±23 min; and cross-clamp time, 49±17 min). Perioperative intraaortic balloon pump was necessary in five patients (3.9%). There was no operative mortality or morbidity. During the follow-up period of 2–30 months, none of the patients had any complication. Postoperative coronary angiography in 54 patients (42.5%) documented excellent early patency rates (LIMA 100%, and RA 98.1%). Conclusions: We believe that keeping our technique in their armamentarium will be useful for cardiac surgeons as an alternative method during complete arterial revascularization. This approach allows for complete arterial revascularization in multi-vessel CAD using only single IMA and RA grafts with excellent early results.


Related Articles

  • Competitive flow and arterial graft a word of caution. Glineur, David; Hanet, Claude // European Journal of Cardio-Thoracic Surgery;Apr2012, Vol. 41 Issue 4, p768 

    In this article, the author comments on competitive flow in arterial grafting. He mentions that due to the lower pressure in the distal portion, competitive flow is more frequent at the right coronary anastomosis of composite Y grafts. He concludes that optimization of myocardial...

  • Structural features of arterial grafts important for surgical myocardial revascularization: Part II - Histology of the radial, inferior epigastric, and right gastroepiploic arteries. Borović, Milica M. Labudović; Kostić, Jelena T.; Borović, Saša D.; Zaletel, Ivan V.; Dželebdžić, Sanja M.; Puškaš, Nela S.; Kostić, Jelena V.; Trifunović, Zoran Ž. // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;Dec2015, Vol. 72 Issue 12, p1111 

    No abstract available.


    Bypass arterial grafts have been performed to the anterior tibial, posterior tibial (below the peroneal), and peroneal arteries in 8 patients with occlusive arterial disease. 2. Six of the eight patients exhibit excellent clinical improvement and femoral arteriogram revealed patent grafts at the...

  • Myocardial Revascularization with the Gastroepiploic Artery. Aramendi, Jos� I.; Castellanos, Enrique; Ortiz de Salazar, Alvaro; O�ate, August�n; Mu�oz, Fernando; Anto�ana, Mikel // Vascular Surgery;Nov/Dec1993, Vol. 27 Issue 9, p673 

    Between July, 1990, and January, 1992, 21 consecutive patients underwent myocardial revascularization with the use of the right gastroepiploic artery, among other grafts. They were 20 men and 1 woman, with a mean age of fifty-five years (range: thirty-seven to seventy). Previous myocardial...

  • Axillary artery to left anterior descending coronary artery bypass with an externally stented graft: a technical report. Athanasiou, Thanos; Kapetanakis, Emmanouil I.; Rao, Christopher; Salvador, Loris; Darzi, Ara // Journal of Cardiothoracic Surgery;2008, Vol. 3, Special section p1 

    With the proliferation of minimally invasive cardiac surgery a number of alternative inflow sites for coronary artery bypass grafting have been utilized, especially in higher risk patients. The use of axillary-coronary artery bypass is a safe and effective alternative especially in the case of...

  • Coronary artery bypass grafts: assessment of graft patency and native coronary artery lesions using 16-slice MDCT. Stauder, Norbert I.; Küttner, Axel; Schröder, Stephen; Drosch, Tanja; Beck, Torsten; Stauder, Heidrun; Blumenstock, Gunnar; Claussen, Claus D.; Kopp, Andreas F.; Küttner, Axel; Schröder, Stephen // European Radiology;Nov2006, Vol. 16 Issue 11, p2512 

    The objective of this study was to evaluate the accuracy of electrocardiography (ECG)-gated 16-slice multidetector-row computed tomography (MDCT) in detection of stenosis of bypass grafts and native coronary arteries in patients who have undergone coronary artery bypass grafting (CABG)....

  • The Radial Artery in Coronary Surgery -- Our Initial Clinical Experience. L., Moraru; V., Raicea; V., Șerban; A., Ivănescu; Dana, Ghiga; Klara, Brânzaniuc; R., Deac // Acta Medica Marisiensis;Aug2011, Vol. 57 Issue 4, p316 

    Objective: We compared in our experience the radial artery harvested in the skeletonized versus pedicled manner as an additional arterial graft for coronary surgery. Material and methods: In this study we evaluated the results obtained of 47 patients to whom we harvested the radial artery using...

  • The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts. Gaiotto, Fábio Antonio; Vianna, Caio B.; Busnardo, Fabio F.; Parga, José R.; de Oliveira Dallan, Luis Alberto; Cesar, Luis A. M.; Stolf, Noedir A. G.; Jatene, Fabio B. // Brazilian Journal of Cardiovascular Surgery;jul-sep2013, Vol. 28 Issue 3, p317 

    Introduction: The descending branch of the lateral femoral circumflex artery is an option for coronary artery bypass grafting. Objective: To evaluate the early patency and adaptation of lumen diameter using multidetector computed angiotomography. Methods: Thirty-two patients were selected to...

  • Factors associated to hypoxemia in patients undergoing coronary artery bypass grafting. dos Santos, Natália Pereira; Mitsunaga, Rodrigo Martins; Borges, Daniel Lago; de Albuquerque Gonçalves Costa, Marina; Pereira Baldez, Thiago Eduardo; Lima, Ilka Mendes; Fonseca Moura, Karol Cristina; da Silva Lula, Josimary Lima // Brazilian Journal of Cardiovascular Surgery;jul-sep2013, Vol. 28 Issue 3, p364 

    Introduction: Hypoxemia is a frequent pulmonary complication in the postoperative coronary artery bypass graft. Detection of factors associated with their occurrence may indicate patients at risk for this complication, which allows tracing specific therapeutic and consequently reduce morbidity...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics