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

Ioanna A. Apostolidou*, Nikolaos J. Skubas, George J. Despotis, Ermioni Kallinteri, Charles W. Hogue, Demetrios G. Lappas, Hendrick B. Barner

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

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 ≥1 mm and ≥2 mm at J +60 msec and lasting ≥1 minute using 2-channel Holter monitoring. During the post-cardiopulmonary bypass period, a significantly higher number of patients with ≥2 mm ischemic episodes (21.7%; p = 0.015) and higher number of ≥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 ≥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 ≥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 ≥2 mm postrevascularization ischemic episodes.

Original languageEnglish (US)
Pages (from-to)433-438
Number of pages6
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume15
Issue number4
DOIs
StatePublished - Jan 1 2001

Keywords

  • Arterial conduits
  • Coronary artery bypass graft surgery
  • Perioperative myocardial ischemia
  • Radial artery conduit

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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