One-year outcomes after coronary artery bypass grafting with radial artery graft in patients with diffuse coronary artery disease

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Objective. To analyze one-year clinical outcomes and radial artery (RA) graft patency in patients with diffuse coronary artery disease (CAD). Material and Methods. A retrospective study enrolled 149 patients with diffuse CAD who underwent CABG between April 2020 and April 2021. RA graft was used in 58 patients (group 1). Other ones (n=91) comprised the 2nd group (conventional CABG using left mammary artery (MA) and saphenous veins). Decision making on the right mammary artery grafting was individual. We created propensity score-matched (PSM) pairs without replacement (1:1 match) (49 patients in each group). All eligible patients underwent CT-angiography in about 12 months after surgery (n=61, 62.2%). We visualized 229 coronary grafts including 103 arterial grafts (left MA 61, right MA 12, RA 30) and 126 venous grafts. Clinical outcomes and angiography data were analyzed. Results. Preoperative clinical and demographical data were similar after PSM. Males prevailed (87.8% and 83.7%, respectively). Mean age was similar (60.7±8.3 and 63.2±9.2 years, respectively). Aortic cross-clamping and cardiopulmonary bypass time, as well as revascularization index were similar. There was only 1 postoperative myocardial infarction with unfavorable outcome in the 2nd group. No major cardiovascular events were found in the 1st group. Annual incidence of myocardial infarction was comparable (2.1% vs 4.3%). Angina recurrence was diagnosed in 10.6 and 15.2% of patients, respectively. CT-angiography revealed 2.4-fold higher incidence of venous graft dysfunction compared to arterial grafts (11.1% vs 3.9%; OR=2.4, 95% CI 0.8—7.4, p=0.096) and 1.4-fold higher incidence compared to RA grafts (11.1% vs 6.7%; OR=1.4, 95% CI 0.3—6.0, p=0.623). Conclusion. CABG with RA grafts demonstrates satisfactory clinical outcomes in patients with diffuse CAD. Analysis of benefits of RA grafts over venous grafts requires further investigations.

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