Department of Anesthesiology

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Occurrence of myocardial ischemia immediately after coronary revascularization using radial arterial conduits.

TitleOccurrence of myocardial ischemia immediately after coronary revascularization using radial arterial conduits.
Publication TypeJournal Article
Year of Publication2001
AuthorsApostolidou IA, Skubas NJ, Despotis GJ, Kallinteri E, Hogue CW, Lappas DG, Barner HB
JournalJ Cardiothorac Vasc Anesth
Volume15
Issue4
Pagination433-8
Date Published2001 Aug
ISSN1053-0770
KeywordsAged, Coronary Artery Bypass, Electrocardiography, Female, Hemodynamics, Humans, Intraoperative Complications, Male, Mammary Arteries, Middle Aged, Monitoring, Intraoperative, Multivariate Analysis, Myocardial Ischemia, Postoperative Complications, Radial Artery, Saphenous Vein
Abstract

OBJECTIVE: To assess the incidence of myocardial ischemia in patients receiving radial arterial and left internal thoracic arterial conduits (RA+LITA) during the postrevascularization period.

DESIGN: Nonrandomized observational sequential cohort.

SETTING: University hospital.

PARTICIPANTS: Thirty adult patients, scheduled for elective coronary artery bypass graft surgery with RA+LITA, compared with 30 patients who received saphenous vein graft and left internal thoracic arterial conduits.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Myocardial ischemic episodes were defined as reversible ST-segment depressions or elevations >or=1 mm and >or=2 mm at J +60 msec and lasting >or=1 minute using 2-channel Holter monitoring. During the post-cardiopulmonary bypass period, a significantly higher number of patients with >or=2 mm ischemic episodes (21.7%; p = 0.015) and higher number of >or=2 mm ischemic episodes per hour (0.19 +/- 0.4 episodes/hr; p = 0.03) were observed in the radial artery group versus the comparison group (0% of patients and 0 episodes/hr). During the postoperative period (24 hours), a significantly longer duration of >or=2 mm ischemic episodes was observed in the radial artery group (24 +/- 33 minutes v 8.4 +/- 21 minutes; p = 0.046). Radial artery graft, preoperative calcium antagonists, and pulmonary arterial mean pressure were independent predictors of the duration and area under the ST-segment curve of >or=2 mm ischemic episodes during the postoperative period.

CONCLUSION: There is an association between the use of the radial artery graft and the incidence and severity of >or=2 mm postrevascularization ischemic episodes.

DOI10.1053/jcan.2001.24958
Alternate JournalJ. Cardiothorac. Vasc. Anesth.
PubMed ID11505345