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  • Title: Occurrence of myocardial ischemia immediately after coronary revascularization using radial arterial conduits.
    Author: Apostolidou IA, Skubas NJ, Despotis GJ, Kallinteri E, Hogue CW, Lappas DG, Barner HB.
    Journal: J Cardiothorac Vasc Anesth; 2001 Aug; 15(4):433-8. PubMed ID: 11505345.
    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.
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