Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (9): 84-91.doi: 10.6040/j.issn.1671-7554.0.2024.1063

• Clinical Research • Previous Articles    

Outcomes of a Y-composite arterial graft using free right internal mammary artery and radial artery for patients undergoing total arterialization myocardial revascularization in multi-center in China

GUO Ke1, CHEN Xujun2, SHI Chao3, LUO Junhui4, YANG Min5, WANG Xiaowu6, WANG Zhendong7, LI Youjin8, MENG Chunying9, CHEN Wensheng10   

  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 Cardiac Surgery, the First Affiliated Hospital of Bengbu Medical University, Bengbu 230004, Anhui, China;
    4. Department of Cardiothoracic Surgery, the 989th Hospital of PLA Joint Logistics, Luoyang 471031, Henan, China;
    5. Department of Cardiac Surgery, Affiliated Hospital of Jiangnan University, Wuxi 214122, Jiangsu, China;
    6. Department of Cardiac Surgery, Zhujiang Hospital of Nanfang University, Guangzhou 510282, Guangdong, China;
    7. Department of Cardiac Surgery, Linfen Peoples Hospital, Linfen 041000, Shanxi, China;
    8. Department of Cardiac Surgery, Peoples Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, Ningxia, China;
    9. Department of Cardiac Surgery, Shenzhen Peoples Hospital, Shenzhen 518020, Guangdong, China;
    10. Department of Cardiothoracic Surgery, Xian Gaoxin Hospital, Xian 710075, Shaanxi, China
  • Published:2025-09-08

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Abstract: Objective To evaluate the safety and efficacy of a composite Y arterial graft(fRIMA-RA-Y graft)using free right internal mammary artery(fRIMA)and radial artery(RA)for patients undergoing total arterial myocardial revascularization(TAR). Methods From January 2020 to May 2024, 112 patients who underwent TAR in 10 hospitals in China and used fRIMA and RA to construct fRIMA-RA-Y bridges were included, including 91 males and 21 females, aged 55.5±11.7 years. Perioperative data and follow-up data after surgery, including survival, echocardiography, and CT angiography(CTA), were collected and analyzed. Results Coronary lesions in all patients were multiple-vessel disease, with 40 cases of severe left main disease. There were 72 patients with diabetes mellitus. All patient underwent TAR by on pump technique. The duration of aorta cross-clamping was 61-100(57.5±11.4)mins and cardiopulmonary bypass time was 79-127(113.4±19.2)mins. Among 112 TAR patients, 112 pedicled LIMA, 112 left RA, 100 right RA and 112 fRIMA conduits were harvested. A total of 112 fRIMA-RA-Y grafts were constructed in in left coronary territory. The number of distal anastomoses was 3-5(4.2±0.7). The duration of mechanical ventilation and ICU stay was 1-18(10.5±7.7)hours and 12-117(23.5±12.9)hours respectively. There was one surgical death. A percent of 7.69%(7/112)of patients were implanted with intraoperative aortic balloon bump. There were 22 patients of new set postoperative atrial fibrillation, 7 of forearm hematoma, 5 of postoperative left chest hemorrhage and 5 of acute renal insufficiency. No chest bone infection occurred. The follow-up duration was 2-49(34.3±5.5)months, with a follow-up rate of 75.89%. There was a significant improvement in left ventricular ejection fraction compared to that of before surgery ［(53.3±5.3)% vs.(62.0±4.5)%, t=17.16, P<0.001］). All patients survived without major adverse cardiovascular or cerebrovascular events during follow-up. It was showed in CTA examination that graft patency of fRIMA-RA-Y graft was 94.12%. Conclusion This multi-center study indicates that fRIMA-RA-Y composite arterial grafts in left coronary territory appears to be safe and effective in TAR patients.

Key words: Coronary artery bypass grafting, Total arterial myocardial Revascularization, Free right internal mammary artery, Radial artery, composite arterial Y grafts, Multi-center

CLC Number: 

  • R654
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