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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.3217.7

Abstract

Coronary revascularistion using left internal mammary artery for the left anterior descending artery has been conclusively proven to have best outcome. However the choice of secondary conduit is still unclear. The right internal mammary artery has shown increased complication rate in diabetic patients. Radial artery has been proposed as alternative but uncommonly used. With the increasing incidence of diabetes need for choosing an optimal secondary conduit is clear. Aims: The aim of this study was to investigate the effectiveness of Radial artery for coronary revascularisation in diabetic patients. Settings and Design: A single unit prospective study. Methods and Material: A total of 132 patients with Diabetes underwent CABG by single unit with radial artery as second arterial conduit. Suitability of radial artery was determined preoperatively. Patients were followed up and underwent CTCAG at the end of five years. Results: One patient suffered MI in immediate postop period and on reopening was secondary to Radial artery spasm requiring revision. Two patients died in perioperative period. We had 125 patients for follow up. At the end of one year, 123 patients survived amounting to 98.3% survival rate. Among the 15 patients who have crossed five years of follow up, we had single mortality with five year survival rate of 93%. All these patients underwent CTCAG, revealing patent LIMA and RADIAL artery grafts but two patients had their vein grafts blocked. Conclusions: The Radial artery maybe recommended as second arterial conduit (in conjunction with the LIMA) for achieving arterial revascularisation in diabetic patients.

 

Keywords : Coronary Artery Disease; Diabetes; Radial Artery Graft; Revascularization. 

Corresponding Author : Manish Pangi, Assistant Professor, Department of Cardiac Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bannerughatta Main Road, Jayanagar 9th Block, Bangalore 560069 Karnataka, India.