Different Anastomosis Methods Of Long-Term Effect Of Proximal Radial Artery In Coronary Artery Bypass Grafting

Objective:Analysis and comparison of different radial artery anastomosis on-pump bypass surgery clinical results in long-term patency rate,whether we can further improve the efficacy of non-arrest bypass surgery.Methods:During the period of 2003 October to 2005 October in our center received off-pump coronary artery bypass grafting,while the use of the radial artery,saphenous vein as graft material of 138 cases of coronary artery bypass grafting;the combination of A group and B group,all patients were collected for review,review of outpatient and telephone the way of follow-up,refer to the general information of the patients before operation and whether there is a history of cerebrovascular accident,whether there is a history of diabetes,hypertension vascular grafts,the number and types of peripheral vascular lesions and clinical data are drinking smoking history.In 138 patients with coronary artery bypass grafting process,only the completion of the follow-up 109 patients(follow-up rate was 78.99%,follow-up time was 67.83 + 42.73 months)follow-up data,including coronary artery bypass surgery in patients with a life or death situation,operation after the recurrence of angina pectoris,acute myocardial infarction,brain stroke(cerebral infarction),hypertension(Hypertension,HTN)and diabetes mellitus(Diabetes,Mellitus,DM)and hypolipidemic drug self-control,target vessel revascularization(Target Vessel,Revascularization,TVR)in patients after coronary artery bypass grafting surgery affect the review of coronary artery CTA or CAG clinical data.Results:A comparison group of patients in group B general information and comparable statistical analysis showed no difference between group A and group B was not statistically significant(P>0.05);A group A and group B in CABG surgery hypertension(Hypertension,HTN),diabetes(Diabetes Mellitus,DM),hyperlipidemia control medication compliance rate,postoperative cerebrovascular accident,after smoking rates,patients after physical exercise and weight control showed no statistically significant difference;A group and B group of patients showed no significant difference in mortality(p = 0.087);calculated using the direct method for group A and postoperative B CABG year(A group A and group B was 100%,chi-square test,p>0.05)and three years(A group 96.55%,group B 96.09%,chi-square test,p>0.05)in overall survival showed no statistically significant difference;A Group A and Group B CABG surgery a year(A group and group B was 100%,chi-square test,p>0.05)and three years(A group 94.83%,group B 92.16%,chi-square test,p>0.05)without major adverse cardiac events(MACE)incidence statistics The results showed no significant difference;A group and B group,a year after CABG(A group 98.28%,group B 96.09%,chi-square test,p>0.05)and three years(A group 87.93%,group B 84.31%,Chi-square test,p>0.05)in the rate of angina showed no statistically significant difference;A group and B group were statistically compare the overall survival curves showed no difference(Log-rank test,p = 0.915);75 例 patients received postoperative coronary CTA or CAG,a cumulative total of 303 grafts review(by anastomotic count,average 4.04/person).Of which 75 LIMA grafts,was not detected lesions;75 RA bridge graft lesions detected 2(respectively,after 47 and 52 months);153 SVG bridge,detected 37 lesions grafts.Does not consider the time factor,the total proportion of RA patency was higher than SVG(RA 97.33%,SVG116/153,75.81%;p = 0.047).Patients in group A and group B bridge patency time curves showed no significant difference in comparison(Log-rank test p = 0.507)Conclusion:A group and B group compared to patients in the absence of major adverse cardiac event rate,angina rate and graft patency time and overall survival curves showed no significant difference;in the long-term patency of saphenous vein grafts without radial artery bridge vascular high;The incidence of stroke in A group than B group in may reduce the postoperative patients;bridge vascular disease is caused by coronary artery bypass graft surgery patients recurrent angina(angina pectoris)the main reason.