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Comparative assessment of surgical myocardial revascularization using autoarterial and autove-nous conduits in patients with coronary artery disease: In-hospital results

Year: 2023, volume 19 Issue: №4 Pages: 358-365
Heading: Surgery Article type: Original article
Authors: Boyadzhyan G.A., Donakanyan S.A., Shvartz V.A., Petrosyan A.D., Koasari A.K., Sanakoev M.K., Ispiryan A.Yu., Aigumov R.N., Bockeria L.A..
Organization: Bakoulev National Medical Research Center for Cardiovascular Surgery
Summary:

Objective: to evaluate the hospital results of coronary artery bypass grafting using autoarterial and au-tovenous conduits. Material and methods. A randomized clinical trial was conducted. The internal thoracic artery on the left was used in both groups (for shunting the anterior interventricular branch), the remaining conduits, depending on the distribution into groups, were either only the radial artery or the radial artery and the large subcutaneous vein (the study group) or only the large subcutaneous vein (the control group). The outcomes studied were: hospital mortality, myocardial infarction (type 5), cerebrovascular events, respiratory failure, bleeding, cardiac arrhythmias, acute kidney injury, etc. Results. 27 patients were randomized: 12 of whom were included in the study group, and 15 were included in the control group. According to operational and early postoperative data, there were no statistically significant differences between the groups, except for the duration of stay on a ventilator in the ICU: in the study group, the duration of a ventilator was longer than in the control group: 14 (12; 18) hours versus 9.3 (5.8; 13) hours, p=0.034. The most frequent complications were cardiac arrhythmias, as well as AKI. There were no statistically significant differences between the groups according to the outcomes studied. The bed-day after surgery also did not differ statistically significantly between the groups. Conclusion. According to the data obtained, it can be concluded that the first days after surgery, the use of the radial artery does not provide significant advantages compared to the use of a large saphenous vein.

Keywords: arterial conduits, cardiac surgery, complications, coronary heart diseases, venous conduits

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All articles of the authors: Aigumov R.N., Bokeria L.A. , Boyadzhyan G.A., Donakanyan S.A. , Ispiryan A.Yu., Koasary A.K. , Petrosyan A.D. , Sanakoev M.K., Shvartz V.A.

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