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

J Cardiothorac Vasc Anesth. 2001 Aug;15(4):433-8. doi: 10.1053/jcan.2001.24958.


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.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Bypass / methods
  • Electrocardiography
  • Female
  • Hemodynamics
  • Humans
  • Intraoperative Complications / diagnosis
  • Male
  • Mammary Arteries / transplantation
  • Middle Aged
  • Monitoring, Intraoperative
  • Multivariate Analysis
  • Myocardial Ischemia / diagnosis
  • Myocardial Ischemia / etiology*
  • Myocardial Ischemia / physiopathology
  • Postoperative Complications / diagnosis
  • Radial Artery / transplantation
  • Saphenous Vein / transplantation