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

Research output: Contribution to journalArticle

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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  • Cite this

    Apostolidou, I. A., Skubas, N. J., Despotis, G. J., Kallinteri, E., Hogue, C. W., Lappas, D. G., & Barner, H. B. (2001). Occurrence of myocardial ischemia immediately after coronary revascularization using radial arterial conduits. Journal of cardiothoracic and vascular anesthesia, 15(4), 433-438. https://doi.org/10.1053/jcan.2001.24958