Objective: To evaluate the mid-term outcomes of bilateral radial artery (BRA) grafts in coronary artery bypass grafting (CABG). Methods: All perioperative medical records and follow-up results of CABG with BRA grafts in multi-centers of China were analyzed retrospectively. Results: A total of 211 patients (170 males and 41 females) underwent CABG grafting with BRA conduits between August 2013 and September 2018, with a mean age of (56.5±9.7) years old (rang 41 to 73 years). There were 161 cases of triple-vessel disease and 50 cases of two-vessel disease. Ninety patients had diabetes mellitus (DM), 35 patients with peripheral vascular disease, 4 patients with chronic obstructive pulmonary disease and 11 with heart valve disease. Two patients underwent off-pump CABG and 209 patients accepted on-pump CABG with commitment valve surgery. There were 210 cases of total arterial revascularization and 161 cases using left thoracic artery conduits, with a graft number of 2-4 (2.7±0.9). No operation-related death occurred, atrial fibrillation happened in 12 patients, hemothorax in 7 cases, and forearm hematoma in one case, hypoxemia in 13 cases and pneumonia in one case. The duration of mechanical ventilation was (8.3±4.7) hours and the mean hospital length of stay was (7.1±2.9) days. Follow-up was completed in 191 patients (90.52%) with a duration of 3-59 (35.5±9.3) months. The mean left ventricular ejection fraction at 3 months after operation was significantly improved, compared to that of the pre-operation (61.0%±7.2% vs 47.1%±5.3%, P=0.017). All patients survived, except that one died from brain injury. No major cardiac events occurred, with a cumulative survival rate of 100% at 1 year and 99.53% at 3 year after operation, respectively. It was showed in coronary CT angiography (CTA) examination that all grafts in 132 patients were patent at the mean follow-up duration of (21.5±6.4) months. Conclusions: BRA grafts as arterial conduit in CABG are proved to be safe, easy for total arterial revascularization and have good mid-term clinical results.
目的： 探讨双桡动脉桥（BRA）在冠状动脉旁路移植术（CABG）的中期治疗效果。 方法： 回顾性分析2013年8月至2018年9月我国19家医院运用BRA进行CABG的临床资料，包括围手术期并发症及随访结果。 结果： 共有211例患者（男170例，女41例）运用BRA，年龄41~73（56.5±9.7）岁，冠状动脉三支病变161例，双支病变50例。术前合并糖尿病90例，周围血管病35例，慢性阻塞性肺疾病4例，瓣膜病11例。非体外循环CABG 2例，体外循环CABG 209例，同期瓣膜手术11例。161例运用左胸廓内动脉，全动脉化210例，远端吻合口2~4（2.7±0.9）个。无手术死亡，术后心房颤动12例，前臂血肿1例，胸腔出血7例，低氧血症13例，肺部感染1例。气管插管时间3.5~20.3（8.3±4.7）h，术后住院6~13（7.1±2.9）d。共有191例（90.52%）得到随访，随访时间3~59（35.5±9.3）个月。术后3个月左室射血分数明显增加（61.0%±7.2%比47.1%±5.3%，P=0.017）。1例患者术后14个月死于脑外伤，其余均存活，无重要心血管事件发生。62.6%（132例）的患者在术后（21.5±6.4）个月经冠状动脉CT血管造影（CTA）证实BRA通畅。术后1年与3年累积生存率分别为100%与99.53%。 结论： BRA在CABG术围手术期安全、并发症少，易于全动脉化而且中期效果优越。.
Keywords: Coronary artery bypass; Multi-center; Radial artery; Treatment outcome.