ABSTRACTS
Najaarsvergadering Nederlandse Vereniging voor Thoraxchirurgie Nieuwegein, 26 september 2003 Hospital outcome of aorta-radial versus ITA-radial artery grafts;
iexpence in the first 512 patients Pompei E, Ferrari E, Ozdemir HI, Woorst FJ ter, Berreklouw E. Division ofCardio-thoracic Surgery, Catharina Hospital; Eindhoven, The Netherlands.
Introduction. We researched our data to determine whether use of radial artery (RA) led to similar hospital morbidity as use ofin-situ internal thoracic artery (ITA) with vein grafts. We also investigated if use of RA, different RA operative techniques, or number of inflow grafts were predictors for hospital outcome. Methods. Retrospectively, the hospital outcome ofthe first 512 patients with RAs (RA Group) was compared with 108 matched patients with LITA and vein grafts (LITA Control Group). Two subgroups of RA operative techniques were further analysed: 327 patients with RA directly from aorta (Aorta-RA Group), and 185 patients with RA from ITA, as a composite graft (ITA-RA Group). Results. Hospital outcome of the RA Group was similar to that of the LITA Control Group. When all ischemic events (IE) were grouped together, univariate analysis showed that Aorta-RA group resulted in less EE than the lTA-RA Group (2,1%versus 5.9%, respectively, p=0,025). Number ofinflow grafts did not influence IE. Multivariate analysis however, did not show that technique ofproximal RA anastomosis or number of inflow grafts were predictors for IE. Condusion. Hospital outcome after the use ofthe radial artery is similar to that ofLITA with vein grafts. Univariate analysis shows less ischemic events after direct aorta-radial artery anastomosis, but multivanate analysis did not show that technique of proximal radial artery anastomosis or number of inflow grafts are important predictors for hospital outcome. Long-term follow-up of total arterial compared to mixed arterialvenous coronary artery bypass grafting in three vessel disease GFV Panday, N Veeger, AA Voors, JG Grandjean, J Meer van der, PW Boonstra. Thoraxcenter, University Hospital Groningen, The Netherlands.
Introduction. One venous graft and one arterial graft are used as bypasses in the majority of coronary artery bypass grafting surgery. However, we started using three arterial grafts in coronary patients with three vessel disease in 1989; both left internal mammary artery (LIMA), right internal mammary artery (RIMA) and gastroepiploic arteries (GEA) (LRGgroup) were used as bypasses. We completed long-term follow-up of this consecutive LRG-group, and compared it with long term followup of patients in whom one venous graft and one LIMA were used. Methods. Between 1989 and 2001, 451 patients underwent total arterial revascularization. MajorAdverse Cardiac Events (MACE) were defined as cardiac mortality, myocardial infarction and reintervention (PTCA or redo-CABG). Follow-up was done by telephone interviews ofpatients and studying medical files ofthe cardiologist and/or general practitioner. The control group existed of 443 patients, who were operated upon with the use of one venous graft and one arterial graft. Results. Both groups were comparable in regard to age, sex, period of operation and number of diseased vessels. Mean follow-up of the survivors ofthe LRG-group was 8.8 years (range 0.1-12.9 years) compared to 11.4 years (range 0.04-12.9 years) in the control group. At the end of follow-up, MACE occurred in 36% of the LRG-group versus 51% in the control group. Kaplan-Meier curves demonstrated a significant decrease of MACE in the LRG-group (Logrank: p90, 68% between 50 and 90 and 19% ofthe patients
Najaarsvergadering Nederlandse Vereniging voor Thoraxchirurgie Nieuwegein, 26 september 2003 Hospital outcome of aorta-radial versus ITA-radial artery grafts;
iexpence in the first 512 patients Pompei E, Ferrari E, Ozdemir HI, Woorst FJ ter, Berreklouw E. Division ofCardio-thoracic Surgery, Catharina Hospital; Eindhoven, The Netherlands.
Introduction. We researched our data to determine whether use of radial artery (RA) led to similar hospital morbidity as use ofin-situ internal thoracic artery (ITA) with vein grafts. We also investigated if use of RA, different RA operative techniques, or number of inflow grafts were predictors for hospital outcome. Methods. Retrospectively, the hospital outcome ofthe first 512 patients with RAs (RA Group) was compared with 108 matched patients with LITA and vein grafts (LITA Control Group). Two subgroups of RA operative techniques were further analysed: 327 patients with RA directly from aorta (Aorta-RA Group), and 185 patients with RA from ITA, as a composite graft (ITA-RA Group). Results. Hospital outcome of the RA Group was similar to that of the LITA Control Group. When all ischemic events (IE) were grouped together, univariate analysis showed that Aorta-RA group resulted in less EE than the lTA-RA Group (2,1%versus 5.9%, respectively, p=0,025). Number ofinflow grafts did not influence IE. Multivariate analysis however, did not show that technique ofproximal RA anastomosis or number of inflow grafts were predictors for IE. Condusion. Hospital outcome after the use ofthe radial artery is similar to that ofLITA with vein grafts. Univariate analysis shows less ischemic events after direct aorta-radial artery anastomosis, but multivanate analysis did not show that technique of proximal radial artery anastomosis or number of inflow grafts are important predictors for hospital outcome. Long-term follow-up of total arterial compared to mixed arterialvenous coronary artery bypass grafting in three vessel disease GFV Panday, N Veeger, AA Voors, JG Grandjean, J Meer van der, PW Boonstra. Thoraxcenter, University Hospital Groningen, The Netherlands.
Introduction. One venous graft and one arterial graft are used as bypasses in the majority of coronary artery bypass grafting surgery. However, we started using three arterial grafts in coronary patients with three vessel disease in 1989; both left internal mammary artery (LIMA), right internal mammary artery (RIMA) and gastroepiploic arteries (GEA) (LRGgroup) were used as bypasses. We completed long-term follow-up of this consecutive LRG-group, and compared it with long term followup of patients in whom one venous graft and one LIMA were used. Methods. Between 1989 and 2001, 451 patients underwent total arterial revascularization. MajorAdverse Cardiac Events (MACE) were defined as cardiac mortality, myocardial infarction and reintervention (PTCA or redo-CABG). Follow-up was done by telephone interviews ofpatients and studying medical files ofthe cardiologist and/or general practitioner. The control group existed of 443 patients, who were operated upon with the use of one venous graft and one arterial graft. Results. Both groups were comparable in regard to age, sex, period of operation and number of diseased vessels. Mean follow-up of the survivors ofthe LRG-group was 8.8 years (range 0.1-12.9 years) compared to 11.4 years (range 0.04-12.9 years) in the control group. At the end of follow-up, MACE occurred in 36% of the LRG-group versus 51% in the control group. Kaplan-Meier curves demonstrated a significant decrease of MACE in the LRG-group (Logrank: p90, 68% between 50 and 90 and 19% ofthe patients
