Comparative Observation Of Graft Patency In Patients With Multiple Coronary Artery Diseases Who Underwent CABG With Left Internal Mammary Artery Combined With Radial Artery Versus Saphenous Vein Graft One Year After Operation

Objective The patency of bridging vessels in patients with multiple coronary artery diseases who underwent coronary artery bypass grafting（coronary artery bypass grafting,CABG）with left internal mammary artery（left internal mammary artery,LIMA）combined with radial artery（radial artery,RA）versus saphenous vein graft（saphenous vein graft,SVG）was observed and compared one year after operationMethods Sixty-seven patients with multi-vessel coronary artery disease treated by CABG were divided into RA group and SVG group according to the mode of operation.35 patients in RA group received CABG with LIMA+RA as bridging vessels,and 32 patients in SVG group received CABG with LIMA+SVG as bridging vessels.The postoperative hospital stay,ICU monitoring time,postoperative complications（pulmonary infection,multiple opening of sternum,renal insufficiency,secondary exploration to stop bleeding）,wound length and wound healing of operative limb were collected and compared between the two groups.One year after operation,coronary CTA and color Doppler echocardiography were performed to evaluate the early patency of bridging vessels.The incidence of cardio-cerebrovascular events（angina pectoris,myocardial infarction,cerebral infarction,secondary revascularization）,postoperative survival and operative limb complications were collected and compared between the two groups.Results Patients in both groups successfully completed CABG graft under cardiopulmonary bypass.A total of 86 bridging vessels were involved in RA group,including 35 LIMA bridging vessels and 51 RA bridging vessels.A total of 97 bridging vessels were involved in SVG group,including 32 LIMA bridging vessels and 65 SVG bridging vessels.The postoperative hospital stay,the probability of pulmonary infection,the length of operative limb wound and the probability of poor wound healing in RA group were lower than those in SVG group（P < 0.05）.LIMA bridging vessels were unobstructed in both groups.One year after operation,there was no significant difference between the patency rate of RA bridging vessels（84.3%）in RA group and SVG bridging vessels（86.2%）in SVG group（P > 0.05）.However,compared with SVG bridginge vessels in SVG group,the patency rate of RA bridging vessels in RA group was more likely to show "linear sign"（P < 0.05）.There was no significant difference between the two groups in the incidence of adverse cardiovascular events,postoperative survival and（or）complications of limb surgery（P > 0.05）.Conclusion The patency rate of RA bridging vessels and SVG bridging vessels in patients with multi-vessel coronary artery disease after CABG one year is higher.Compared with SVG group,patients in RA group have shorter postoperative hospital stay,fewer postoperative complications such as pulmonary infection and more likely to appear "linear sign".