Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery

Long-term results of coronary artery bypass surgery using the internal thoracic and radial arteries

Authors: O.A. Kovalenko, D.E. Musin, K.V. Krymov, M.D. Alshibaya

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2019-16-4-299-305

UDC: 616.132.2-089.843:616.134.5+616.134.31

Link: Clinical Physiology of Blood Circulaiton. 2019; 16 (4): 299-305

Quote as: Kovalenko O.A., Musin D.E., Krymov K.V., Alshibaya M.D. Long-term results of coronary artery bypass surgery using the internal thoracic and radial arteries. Clinical Physiology of Circulation. 2019; 16 (4): 299–305 (in Russ.). DOI: 10.24022/1814-6910-2019-16-4-299-305

Received / Accepted:  30.08.2019/19.09.2019

Full text:  

Abstract

Coronary artery bypass grafting (CABG) remains one of the most effective methods of treatment for patients with coronary artery disease. Selection of the appropriate conduit for the bypass is key to achieving good short- and long-term procedural outcomes. The use of arterial grafts other than the left internal thoracic artery (ITA) to the left anterior descending coronary artery for CABG remains very uncommon. In a recent report on nearly 1.5 million CABG procedures, the rates of use of both ITA and radial arteries (RA) for grafting in the United States were 4.9% and 6.5%, respectively. The fact that a multiple-arterial grafting strategy is associated with better clinical outcomes and higher patency rates that would justify the greater technical difficulty, longer operative times, and potential complications. However, the long-term results of CABG are few and reflect medium-term results.
The paper presents a clinical study of the patency of arterial (ITA and RA) conduits and a shunt from great saphenous vein (GSM) in one patient over a 16-year observations. These data are confirmed by the results of instrumental studies (coronary angiography, echocardiography). During the observed period, the patient strictly adhered to standard drug therapy. On the coronarography, it was found that for 16 years there has been a functional patency of bypass from the ITA and RA. And GSM bypass was occluded. Performing angioplasty and stenting of this coronary artery. It should be noted that one of the main criteria for the satisfactory function of bypass is the preservation of the corresponding circulation pools.
The results of this dynamic observation of the viability of conduits over a 16-year period indicate the need for widespread use of arterial conduits.

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About Authors

  • Oleg A. Kovalenko, Dr. Med. Sc., Leading Researcher; orcid.org/0000-0003-4485-3964
  • Dzhanybek E. Musin, Cand. Med. Sc., Leading Researcher; orcid.org/0000-0002-6265-2309
  • Konstantin V. Krymov, Researcher; orcid.org/0000-0002-4833-5075
  • Mikhail D. Alshibaya, Dr. Med. Sc., Professor, Head of Department of Surgical Treatment of Coronary Heart Disease; orcid.org/0000-0002-8003-5523

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