Outcomes of Radial Artery Grafts Without Postoperative Calcium Channel
Blocker Administration
Abstract
Background: Guidelines encourage oral pharmacologic antispasmodic
therapy for patients receiving a radial artery conduit during coronary
artery bypass grafting. We review our experience with radial artery
conduits without the postoperative use of calcium channel blocker
therapy. Methods: A single-center, retrospective review patients
undergoing isolated coronary artery bypass grafting with at least one
radial artery conduit over a three-year period was performed. Patient
demographic, operative, and post-discharge data were collected.
Development of angina or angina equivalent symptoms, imaging suggestive
of radial conduit failure, or percutaneous intervention to the territory
grafted by a radial artery was considered to represent graft failure.
Patients were evaluated for primary outcomes through 90 days
postoperatively and followed for 1 year overall. Results: 264 adult
patients underwent first-time, isolated coronary artery bypass grafting
with use of a radial artery conduit. Three patients were observed to
have radial graft occlusions during the first 90 days, all of which were
attributed to technical issues. No patients required addition of a
calcium channel blocker & no additional patients underwent imaging or
intervention for radial graft failure during 1 year of follow up.
Conclusions: Avoidance of postoperative calcium channel blocker therapy
in patients receiving a radial artery graft was not associated with a
high incidence of imaging-confirmed or clinically suggested conduit
failure.