Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (5): 18-25.doi: 10.6040/j.issn.1671-7554.0.2024.0850

• Special Topic on Application of Arterial Grafts in Coronary Artery Bypass Grafting • Previous Articles    

Multi-center mid-term clinical outcomes in coronary patients undergoing total arterial bypass surgery with anatomic complete revascularization in China

GUO Ke1, CHEN Xujun2, ZHENG Baoshi3, HUANG Keli4, WANG Xiaowu5, CHEN Jingwei6, LIN Yu7, LUO Junhui8, WANG Haichen9, WANG Zhendong10, LIAO Chengquan11, LI Youjin12, CHEN Wensheng13   

  1. 1. Department of Cardiovascular Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou, China;
    2. Department of Cardiac Surgery, Wuhan First Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei, China;
    3. Department of Cardiovascular Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China;
    4. Cardiac Surgery Center, Sichuan Provincial Peoples Hospital, Chengdu 610072, Sichuan, China;
    5. Department of Cardiovascular Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong, China;
    6. Department of Cardiovascular Surgery, Peoples Hospital of Maoming City, Maoming 525000, Guangdong, China;
    7. Department of Cardiovascular Surgery, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510006, Guangdong, China;
    8. Department of Cardiothoracic Surgery, 989 Hospital of the Joint Service Force of the Chinese Peoples Liberation Army, Luoyang 471031, Henan, China;
    9. Department of Cardiovascular Surgery, First Affiliated Hospital of Xian Jiaotong University, Xian 710061, Shaanxi, China;
    10. Department of Cardiovascular Surgery, Linfen Peoples Hospital, Linfen 041000, Shanxi, China;
    11. Department of Cardiovascular Surgery, Yuebei Peoples Hospital, Shaoguan 512026, Guangdong, China;
    12. Department of Cardiovascular Surgery, Ningxia Hui Autonomous Region Peoples Hospital, Yinchuan 750002, Ningxia, China;
    13. Department of Cardiovascular Surgery, Xian High-tech Hospital, Xian 710075, Shaanxi, China
  • Published:2025-05-07

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Abstract: Objective To evaluate the safety and efficacy of total arterial myocardial revascularization(TAR)with anatomical complete revascularization(ACR)in treatment of coronary heart patients. Methods Between January 2018 and April 2024, a total of 117 patients, including 80 males and 37 females, 33-67 years old, with an age of(55.5±9.7)years, received TAR in 13 cardic surgery centers. There were 50 patients with primary hypertension and 57 patients with diabetes mellitus. Among them, there were 47 of severe left main lescons and 103 of triple vessel lesions, including 33 cases of chronic total occlusions. Results A total of 117 pedicled left internal mammary artery(LIMA), 117 left radial artery(LRA), 114 right radial artery(RRA), and 47 free right mammary artery grafts(RIMA)were observed in 117 patients. A total of 57 composite Y arterial grafts were constructed while the rest were single arterial graft. The number of distal anastomosis was(4.2±0.4). The time for ascending aorta clamp and bypass duration was(101.5±15.4 )minutes and(145.4±19.2)minutes, respectively. The duration of tracheal intubation was(8.5±9.3)hours. Intraoperative aortic balloon bump was implanted in 21 cases. Postoperatively, 10 patients developed atrial fibrillation, 6 had forearm hematomas, 1 experienced myocardial infarction, and 5 developed acute renal insufficiency. No surgical deaths occurred. No patients had chest bone infections/non healing. The follow-up duration was(64.3±7.5)months, with a 100% follow-up rate. During the follow-up period, 3 patients died, among them, 2 of COVID-19 and 1 of colon cancer. It was showed that left ventricular ejection fraction ［(60.3%±9.3%)vs.(55.0%±7.3%), t=20.01, P<0.001］ and cardiac function(94.74% vs. 80.34%, New York Heart Association class ≤ 2, χ2=10.90, P<0.001)were improved significantly. A total of 91 patients underwent CT angiography(CTA), with duration of(40.5±7.7)months and it was showed that patency rates of LIMA, LRA, RRA, and RIMA was 97.80%, 86.81%, 93.41%, and 94.50% respectively in CTA(χ2=9.062, P=0.028). Conclusion This multicenter study preliminarily confirmed that TAR with ACR is safe in the short-term and has satisfactory results in the med-term in the treatment of coronary artery disease.

Key words: Coronary heart disease, Coronary artery bypass grafting, Total arterial, Anatomic complete revascularization, Multi-center, Mid-term outcome

CLC Number: 

  • R654
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