Off-Pump All Arterial Coronary Artery Bypass Grafting

Main Article Content

Permyos Ruengsakulrach, MD., PhD, FRCST

Abstract

There is growing acceptance of the long-term durability of using coronary artery bypass grafting (CABG) for the treatment of coronary artery disease(CAD).The idea is to give an antegrade flow to the coronary artery circulation, thereby relieving  angina. CABG  as  used  in   clinical   practice   since the 1960s, is arguably the most intensively studied surgical procedure ever, while percutaneous coronary intervention (PCI), used for over three decades, has been subjected to more randomized clinical trials (RCTs) than any other interventional procedure. In comparison with CABG, PCI unfortunately has a higher rate of reintervention. In 2009, the American College of Cardiology (ACC), Society for Cardiovascular Angiography and Interventions (SCAI), Society of Thoracic Surgeons (STS), American Association for Thoracic Surgery (AATS), American Heart Association (AHA), and the American Society of Nuclear Cardiology (ASNC) jointly launched appropriateness criteria for revascularization.1 Appropriateness criteria are based on current understanding of the technical capabilities and potential patient benefits of the procedures examined. Coronary revascularization   is appropriate when the expected benefits, in terms of survival or health outcomes (symptoms, functional status, and/or quality of life) exceed the expected negative consequences of the procedure. The methods of revascularization depend mainly on symptoms, clinical presentations and coronary artery anatomy. Generally, surgery is mostly appropriate except for certain situations, for example, prior bypass surgery with native triple vessel disease, and failure of multiple bypass grafts with patent left internal thoracic artery (LITA) to the native coronary artery, depressed left ventricular ejection fraction. Percutaneous coronary intervention (PCI) has many uncertainties and may be inappropriate in the following conditions: left main (LM) coronary artery disease; multivessel coronary artery disease associated with diabetes, and depressed left ventricular function.

Downloads

Download data is not yet available.

Article Details

How to Cite
1.
Ruengsakulrach P. Off-Pump All Arterial Coronary Artery Bypass Grafting. BKK Med J [Internet]. 2011Feb.18 [cited 2020Jul.16];1(1):32. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/217660
Section
Reviews Article

References

1. Patel MR, Dehmer GJ, Hirshfeld JW, Smith PK, Spertus JA. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appro priateness Criteria for Coronary Revascularization: A Report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology: Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.Circulation 2009;119(9):1330-1352
2. Guidelines on myocardial revascularization. Eur J Cardiothorac Surg 2010;38:1-52
3. Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, van den Brand M, Van Dyck N, Russell ME, Mohr FW, Serruys PW. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention 2005;1(2):219-227
4. Shahian DM, O’Brien SM, Filardo G, Ferraris VA, Haan CK, Rich JB, Normand SL, DeLong ER, Shewan CM, Dokholyan RS, Peterson ED, Edwards FH,Anderson RP. The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 1-coronary artery bypass grafting surgery. Ann Thorac Surg 2009;88:2-22
5. Roques F, Nashef SA, Michel P, Gauducheau E, de Vincentiis C, Baudet E, Cortina J, David M, Faichney A, Gabrielle F, Gams E, Harjula A, Jones MT, Pintor, PP, Salamon R, Thulin L. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg 1999;15(6):816-822
6. Nashef SA, Roques F, Hammill BG, Peterson ED, Michel P, Grover FL, Wyse RK, Ferguson TB. Validation of European System for Cardiac Operative Risk Evaluation (EuroSCORE) in North American cardiac surgery. Eur J Cardiothorac Surg 2002;22(1): 101-105
7. Nilsson J, Algotsson L, Hoglund P, Luhrs C, Brandt J Early mortality in coronary bypass surgery: the Euro-SCORE versus The Society of Thoracic Surgeons risk algorithm. Ann Thorac Surg 2004;77(4):1235-1240
8. Gogbashian A, Sedrakyan A, Treasure T. EuroSCORE: a systematic review of international performance. Eur J Cardiothorac Surg 2004;25(5):695-700
9. Toumpoulis IK, Anagnostopoulos CE, Toumpoulis SK, DeRose JJ, Jr., Swistel DG. EuroSCORE predicts longterm mortality after heart valve surgery. Ann Thorac Surg 2005;79(6):1902-1908
10. Nilsson J, Algotsson L, Hoglund P, Luhrs C, Brandt J. EuroSCORE predicts intensive care unit stay and costs of open heart surgery. Ann Thorac Surg 2004;78 (5):1528-1534
11. Pinna Pintor P, Bobbio M, Colangelo S, Veglia F, Marras R, Diena M. Can EuroSCORE predict direct costs of cardiac surgery? Eur J Cardiothorac Surg 2003;23 (4):595-598
12. Murphy GJ,Angelini GD. Side effects ofcardiopulmonary bypass: what is the reality? J Card Surg 2004;19 (6):481-488.
13. Mueller RL, Rosengart TK, Isom OW. The history of surgery for ischemic heart disease. Ann Thorac Surg 1997;63(3):869-878
14. Peric M, Huskic R, Nastasic S, Jocic Z, Nezic D, Vuk F, Neskovic A, Bojic M. [History of surgical treatment of atherosclerosis of the coronary arteries-the first 100 years]. Acta Chir Iugosl 2000;47(1-2):9-16
15. Morris JB, Schirmer WJ. The “right stuff”: five Nobel Prize-winning surgeons. Surgery 1990;108(1):71-80
16. Akerman J. Alexis Carrel: Nobel Prize for physiology andmedicine, 1912. By Professor JulesAkerman, member of the Medical Nobel Committee. Transplant Proc 1987;19:9-11
17. KonstantinovIE.Thefirstcoronaryarterybypassoperation and forgotten pioneers. Ann Thorac Surg 1997;64 (5):1522-1523
18. Konstantinov IE. Robert H. Goetz: the surgeon who performed the first successful clinical coronary artery bypass operation. Ann Thorac Surg 2000;69(6):1966-1972
19. Goetz RH, Rohman M, Haller JD, Dee R, Rosenak SS. Internal mammary-coronary artery anastomosis. A nonsuturemethod employing tantalum rings. J Thorac Cardiovasc Surg 1961;41:378-386
20. Effler DB. Vasilii I. Kolesov: pioneer in coronary revascularization. J Thorac Cardiovasc Surg.1988;96 (1):183
21. Kolesov VI. [Initial experience in the treatment of stenocardia by the formation of coronary-systemic vascular anastomoses]. Kardiologiia 1967;7(4):20-25
22. Murray G, Porcheron R, Hilario J, Roschlau W. Anastomosis of systemic artery to the coronary. Can Med Assoc J 1954;71(6):594-597
23. Proudfit WL. In memoriam F. Mason Sones, Jr., M.D. (1918-1985): the man and his work. Cleve Clin Q 1986;53(2):121-124
24. Effler DB, Groves LK, Sones FM, Jr., Shirey EK. Endarterectomy in the treatment of coronary artery disease. J Thorac Cardiovasc Surg 1964;47:98-108
25. Favaloro RG. Saphenous vein autograft replacement of severe segmental coronary artery occlusion: operative technique. Ann Thorac Surg 1968;5(4):334-339
26. Sabiston DC, Jr. The William F. Rienhoff, Jr. Lecture. The coronary circulation. Johns Hopkins Med J 1974;134(6):314-329
27. Garrett HE, Dennis EW, DeBakey ME. Aortocoronary bypass with saphenous vein graft. Seven-year followup. JAMA 1973;223(7):792-794
28. Green GE, Stertzer SH, Reppert EH. Coronary arterial bypass grafts. Ann Thorac Surg 1968;5(5):443-450
29. Gibbon JH, Jr. Application of a mechanical heart and lung apparatus to cardiac surgery. Minn Med 1954;37 (3):171-185
30. Stoney WS. Evolution of cardiopulmonary bypass.Circulation 2009;119(21):2844-2853
31. Dubost C, Blondeau P, Piwnica A, Weiss M, Lenfant C, Passelecq J, Guery J. Syphilitic coronary obstruction: correction under artificial heart-lung and profound hypothermia. Surgery 1960;48:540-547
32. Kakos GS, Oldham HN, Jr., Dixon SH, Jr., Davis RW, Hagen PO, Sabiston DC, Jr. Experimental evaluation of coronary hemodynamics after aorto-coronary bypass. Surg Forum 1971;22:147-148
33. Favaloro RG. Surgical treatment of coronary arteriosclerosis by the saphenous vein graft technique. Critical analysis. Am J Cardiol 1971;28(4):493-495
34. Bailey CP, Hirose T, Aventura A, Yamamoto N, Brancato R, Vera C, O’Connor R. Revascularization of the ischemic posterior myocardium. Dis Chest 1967;52 (3):273-285
35. Spencer FC, Yong NK, Prachuabmoh K. Internal mammary-coronary artery anastomoses performed during cardioulmonary bypass. J Cardiovasc Surg (Torino) 1964;5:292-297
36. Kirklin JK, Westaby S, Blackstone EH, Kirklin JW, Chenoweth DE, Pacifico AD. Complement and the damaging effects of cardiopulmonary bypass. J Thorac Cardiovasc Surg 1983;86(6):845-857
37. Buja LM, Weerasinghe P. Unresolved issues in myocardial reperfusion injury. Cardiovasc Pathol 19(1):29-35
38. Healey CM, Kumbhani DJ, Healey NA, Crittenden MD, Gibson SF, Khuri SF. Impact of intraoperative myocardial tissue acidosis on postoperative adverse outcomes and cost of care for patients undergoing prolonged aortic clamping during cardiopulmonary bypass. Am J Surg 2009;197(2):203-210
39. Arom KV, Emery RW, Flavin TF, Kshettry VR, Janey P. Surgical steps toward complete revascularization in off-pump coronary bypass. Asian Cardiovasc Thorac Ann 2002;10(3):201-205
40. Arom KV, Emery RW, Flavin TF, Kshettry VR, Petersen RJ. OPCAB surgery: a critical review of two different categories of pre-operative ejection fraction. Eur J Cardiothorac Surg 2001;20(3):533-537
41. Arom KV, Emery RW, Flavin TF, Petersen RJ. Costeffectiveness of minimally invasive coronary artery bypass surgery. Ann Thorac Surg. 1999;68(4):1562-1566
42. Arom KV, Emery RW, Kshettry VR, Janey PA. Comparison between port-access and less invasive valve surgery.Ann Thorac Surg 1999;68(4):1525-1528
43. Arom KV, Emery RW, Nicoloff DM. Mini-sternotomy for coronary artery bypass grafting. Ann Thorac Surg 1996;61(4):1271-1272
44. Arom KV, Emery RW, Nicoloff DM, Flavin TF, Emery AM. Minimally invasive direct coronary artery bypass grafting: experimental and clinical experiences. Ann Thorac Surg 1997;63(6):48-52
45. Arom KV, Flavin TF, Emery RW, Kshettry VR, Janey PA, Petersen RJ. Safety and efficacy of off-pump coronary artery bypass grafting. Ann Thorac Surg 2000;69 (3):704-710
46. Arom KV, Flavin TF, Emery RW, Kshettry VR, Petersen RJ, Janey PA. Is low ejection fraction safe for offpump coronary bypass operation? Ann Thorac Surg 2000;70(3):1021-1025
47. Kobayashi J, Tashiro T, Ochi M, Yaku H, Watanabe G, Satoh T, Tagusari O, Nakajima H, Kitamura S. Early outcome of a randomized comparison of off-pump and on-pump multiple arterial coronary revascularization. Circulation 2005;112(9):338-343
48. Cleveland JC, Jr., Shroyer AL, Chen AY, Peterson E, Grover FL. Off-pump coronary artery bypass grafting decreases risk-adjusted mortality and morbidity. Ann Thorac Surg 2001;72(4):1282-1289
49. Bainbridge D, Cheng D, Martin J, Novick R. Does offpump or minimally invasive coronary artery bypass reduce mortality, morbidity, and resource utilization when compared with percutaneous coronaryintervention? A meta-analysis of randomized trials. J Thorac Cardiovasc Surg 2007;133(3):623-631
50. Sergeant P, Wouters P, Meyns B, Bert C, Van Hemelrijck J, Bogaerts C, Sergeant G, Slabbaert K. OPCAB versus early mortality and morbidity: an issue between clinical relevance and statistical significance. Eur J Cardiothorac Surg 2004;25(5):779-785
51. Fattouch K, Guccione F, Dioguardi P, Sampognaro R, Corrado E, Caruso M, Ruvolo G. Off-pump versus onpump myocardial revascularization in patients with STsegment elevation myocardial infarction: a randomized trial. J Thorac Cardiovasc Surg 2009;137(3):650-657
52. Magee MJ, Alexander JH, Hafley G, Ferguson TB, Jr., Gibson CM, Harrington RA, Peterson ED, Califf RM, Kouchoukos NT, Herbert MA, Mack MJ. Coronary artery bypass graft failure after on-pump and off-pump coronary artery bypass: findings from PREVENT IV. Ann Thorac Surg 2008;85(2):494-500
53. Kuss O, von Salviati B, Borgermann J. Off-pump versus on-pump coronary artery bypass grafting: A systematic review and meta-analysis of propensity score analyses. J Thorac Cardiovasc Surg 2010;140(4):829-835
54. Greilich PE, Brouse CF, Rinder HM, Jessen ME, Rinder CS, Eberhart RC, Whitten CW, Smith BR. Monocyte activation in on-pump versus off-pump coronary artery bypass surgery. J Cardiothorac Vasc Anesth 2008; 22(3):361-368
55. Dybdahl B, Wahba A, Haaverstad R, Kirkeby-Garstad I, Kierulf P, Espevik T, Sundan A. On-pump versus offpump coronary artery bypass grafting: more heat-shock protein 70 is released after on-pump surgery. Eur J Cardiothorac Surg 2004;25(6):985-992
56. Talpahewa SP, Lovell T, Angelini GD, Ascione R. Effect of cardiopulmonary bypass on cortical cerebral oxygenation during coronary artery bypass grafting. Eur J Cardiothorac Surg 2004;26(4):676-681
57. Lee JD, Lee SJ, Tsushima WT, Yamauchi H, Lau WT, Popper J, Stein A, Johnson D, Lee D, Petrovitch H, Dang CR. Benefits of off-pump bypass on neurologic and clinical morbidity: a prospective randomized trial. Ann Thorac Surg 2003;76(1):18-25
58. Angelini GD, Culliford L, Smith DK, Hamilton MC, Murphy GJ, Ascione R, Baumbach A, Reeves BC. Effects of on- and off-pump coronary artery surgery on graft patency, survival, and health-related quality of life: long-term follow-up of 2 randomized controlled trials. J Thorac Cardiovasc Surg 2009;137(2):295-303
59. Arom KV, Jotisakulratana V, Pitiguagool V, Banyatpiyaphod S, Asawapiyanond S, Pamornsing P, Suwannakijboriharn C, Ruengsakulrach P. Can Surgeons Do Complete Revascularization in Diabetic Patients Using the Off-Pump Technique? Innovations: Technology & Techniques in Cardiothoracic & Vascular Surgery 2007;2(1):1-6
60. Abu-Omar Y, Taggart DP. The present status of offpump coronary artery bypass grafting. Eur J Cardiothorac Surg 2009;36(2):312-321
61. Feng ZZ, Shi J, Zhao XW, Xu ZF. Meta-analysis of onpump and off-pump coronaryarterial revascularization. Ann Thorac Surg 2009;87(3):757-765
62. Moller CH, Penninga L, Wetterslev J, Steinbruchel DA,Gluud C. Clinical outcomes in randomized trials of offvs. on-pump coronary artery bypass surgery: systematic review with meta-analyses and trial sequential analyses. Eur Heart J 2008;29(21):2601-2616
63. Shroyer AL, Grover FL, Hattler B, Collins JF, McDonald GO, Kozora E, Lucke JC, Baltz JH, Novitzky
64. D. On-pump versus off-pump coronary-artery bypass surgery. N Engl J Med 2009;361(19):1827-1837
65. Chu D, Bakaeen FG, Dao TK, Lemaire SA, Coselli JS, Huh J. On-pump versus off-pump coronary artery bypass grafting in a cohort of 63,000 patients. Ann Thorac Surg 2009;87(6):1820-1827
66. Takagi H, Matsui M, Umemoto T. Off-pump coronary artery bypass may increase late mortality: a metaanalysis of randomized trials. Ann Thorac Surg 2010; 89(6):1881- 1888
67. van Dijk D, Nierich AP, Jansen EW, Nathoe HM, Suyker WJ, Diephuis JC, van Boven WJ, Borst C, Buskens E, Grobbee DE, Robles De Medina EO, de Jaegere PP. Early outcome after off-pump versus onpump coronary bypass surgery: results from a randomized study. Circulation 2001;104(15):1761-1766
68. van Dijk D, Spoor M, Hijman R, Nathoe HM, Borst C, Jansen EW, Grobbee DE, de Jaegere PP, Kalkman CJ. Cognitive and cardiac outcomes 5 years after off-pump vs on-pump coronary artery bypass graft surgery. JAMA 2007;297(7):701-708
69. Angelini GD, Taylor FC, Reeves BC, Ascione R. Early and midterm outcome after off-pump and on-pump surgery in Beating Heart Against Cardioplegic Arrest Studies (BHACAS 1 and 2): a pooled analysis of two randomised controlled trials. Lancet 2002;359 (9313):1194-1199
70. Puskas JD, Williams WH, Duke PG, Staples JR, Glas KE, Marshall JJ, Leimbach M, Huber P, Garas S, Sammons BH, McCall SA, Petersen RJ, Bailey DE, Chu H, Mahoney EM, Weintraub WS, Guyton RA. Off-pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury, transfusion requirements and length of stay: a prospective randomized comparison of two hundred unselected patients undergoing off-pump versus conventional coronary artery bypass grafting. J Thorac Cardiovasc Surg 2003;125(4):797-808
71. Muneretto C, Bisleri G, Negri A, Manfredi J, Metra M, Nodari S, Dei Cas L. Off-pump coronary artery bypass surgery technique for total arterial myocardial revascularization: a prospective randomized study. Ann Thorac Surg 2003;76(3):778-78\Khan NE, De Souza A, Mister R, Flather M, Clague J, Davies S, Collins P, Wang D, Sigwart U, Pepper J. A randomized comparison of off-pump and on-pump multivessel coronary-artery bypass surgery. N Engl J Med 2004;350(1):21-28
72. Legare JF, Buth KJ, King S, Wood J, Sullivan JA, Hancock Friesen C, Lee J, Stewart K, Hirsch GM. Coronary bypass surgery performed off pump does not result in lower in-hospital morbidity than coronary artery bypass grafting performed on pump. Circulation 2004;109(7):887-892
73. Al-Ruzzeh S, George S, Bustami M, Wray J, Ilsley C, Athanasiou T, Amrani M. Effect of off-pump coronary artery bypass surgery on clinical, angiographic, neurocognitive, and quality of life outcomes: randomised controlled trial. BMJ 2006;332(7554):1365
74. Moller CH, Perko MJ, Lund JT, Andersen LW, Kelbaek H, Madsen JK, Winkel P, Gluud C, Steinbruchel DA. No major differences in 30-day-outcomes in highrisk patients randomized to off-pump versus on-pump coronary bypass surgery: the best bypass surgery trial. Circulation 121(4):498-504
75. Hueb W, Lopes NH, Pereira AC, Hueb AC, Soares PR, Favarato D, Vieira RD, Lima EG, Garzillo CL, Paulitch Fda S, Cesar LA, Gersh BJ, Ramires JA. Five-year follow-up of a randomized comparison between offpump and on-pump stable multivessel coronary artery bypass grafting. The MASS III Trial. Circulation 122 (11):48-52
76. Sabik JF, 3rd, Lytle BW, Blackstone EH, Houghtaling PL, Cosgrove DM. Comparison of saphenous vein and internal thoracic artery graft patency by coronary system. Ann Thorac Surg 2005;79(2):544-551
77. Goldman S, Zadina K, Moritz T, Ovitt T, Sethi G, Copeland JG, Thottapurathu L, Krasnicka B, Ellis N, Anderson RJ, Henderson W. Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: results from a Department of Veterans Affairs Cooperative Study. J Am Coll Cardiol 2004;44(11):2149-2156
78. Schachner T, Laufer G, Bonatti J. In vivo (animal) models of vein graft disease. Eur J Cardiothorac Surg 2006;30(3):451-463
79. Wallitt EJ, Jevon M, Hornick PI. Therapeutics of vein graft intimal hyperplasia: 100 years on. Ann Thorac Surg 2007;84(1):317-323
80. Lytle BW, Blackstone EH, Sabik JF, Houghtaling P, Loop FD, Cosgrove DM. The effect of bilateral internal thoracic artery grafting on survival during 20 postoperative years. Ann Thorac Surg 2004;78(6): 2005-2012
81. Buxton BF, Ruengsakulrach P, Fuller J, Rosalion A, Reid CM, Tatoulis J. The right internal thoracic artery graft-benefits of grafting the left coronary system and native vessels with a high grade stenosis. Eur J Cardiothorac Surg 2000;18(3):255-261
82. Carpentier A, Guermonprez JL, Deloche A, Frechette C,
83. DuBost C. The aorta-to-coronary radial artery bypass graft. A technique avoiding pathological changes in grafts. Ann Thorac Surg 1973;16(2):111-121
84. Curtis JJ, Stoney WS, Alford WC, Jr., Burrus GR, Thomas CS, Jr. Intimal hyperplasia. A cause of radial artery aortocoronary bypass graft failure. Ann Thorac Surg 1975;20(6):628-635
85. Chiu CJ. Why do radial artery grafts for aortocoronary bypass fail? A reappraisal. Ann Thorac Surg 1976;22 (6):520-523
86. Fisk RL, Brooks CH, Callaghan JC, Dvorkin J. Experience with the radial artery graft for coronary artery bypass. Ann Thorac Surg 1976;21(6):513-518
87. Acar C, Jebara VA, Portoghese M, Beyssen B, Pagny JY, Grare P, Chachques JC, Fabiani JN, Deloche A, Guermonprez JL. Revival of the radial artery for coronary artery bypass grafting. Ann Thorac Surg 1992;54(4):652-660
88. Ruengsakulrach P, Eizenberg N, Fahrer C, Fahrer M, Buxton BF. Surgical implications of variations in hand collateral circulation: anatomy revisited. J Thorac Cardiovasc Surg 2001;122(4):682-686
89. Stary HC, Blankenhorn DH, Chandler AB, Glagov S, Insull W, Jr., Richardson M, Rosenfeld ME, Schaffer SA, Schwartz CJ, Wagner WD, et al. A definition of the intima of human arteries and of its atherosclerosis-prone regions. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Arterioscler Thromb 1992;12(1): 120-134
90. Ruengsakulrach P, Sinclair R, Komeda M, Raman J, Gordon I, Buxton B. Comparative histopathology of radial artery versus internal thoracic artery and risk factors for development of intimal hyperplasia and atherosclerosis. Circulation 1999;100(19):139-144
91. Svendsen E, Dregelid E, Eide GE. Internal elastic membrane in the internal mammary and left anterior descending coronary arteries and its relationship to intimal thickening. Atherosclerosis 1990;83(2-3):239-248
92. Ruengsakulrach P, Brooks M, Sinclair R, Hare D, Gordon I, Buxton B. Prevalence and prediction of calcification and plaques in radial artery grafts by ultrasound. J Thorac Cardiovasc Surg 2001;122(2): 398-399
93. Buxton BF, Raman JS, Ruengsakulrach P, Gordon I, Rosalion A, Bellomo R, Horrigan M, Hare DL. Radial artery patency and clinical outcomes: five-year interim results of a randomized trial. J Thorac Cardiovasc Surg 2003;125(6):1363-1371
94. Hayward PA, Hare DL, Gordon I, Buxton BF. Effect of radial artery or saphenous vein conduit for the second graft on 6-year clinical outcome after coronary artery bypass grafting. Results of a randomised trial. Eur J Cardiothorac Surg 2008;34(1):113-117
95. Desai ND, Cohen EA, Naylor CD, Fremes SE. A randomized comparison of radial-artery and saphenousvein coronary bypass grafts. N Engl J Med 2004;351(22):2302-2309
96. Loop FD, Lytle BW, Cosgrove DM, Stewart RW, Goormastic M, Williams GW, Golding LA, Gill CC, Taylor PC, Sheldon WC, et al. Influence of the internal-mammary-artery graft on 10-year survival and other cardiac events. N Engl J Med 1986;314(1):1-6
97. Tatoulis J, Buxton BF, Fuller JA. Patencies of 2127 arterial to coronary conduits over 15 years. Ann Thorac Surg 2004;77(1):93-101
98. Zhao DX, Leacche M, Balaguer JM, Boudoulas KD, Damp JA, Greelish JP, Byrne JG, Ahmad RM, Ball SK, Cleator JH, Deegan RJ, Eagle SS, Fong PP, Fredi JL, Hoff SJ, Jennings HS, 3rd, McPherson JA, Piana RN, Pretorius M, Robbins MA, Slosky DA, Thompson A. Routine intraoperative completion angiography after coronary artery bypass grafting and 1-stop hybrid revascularization results from a fully integrated hybrid catheterization laboratory/ operating room. J Am Coll Cardiol 2009;53(3):232-241
99. Muneretto C, Bisleri G, Negri A, Manfredi J, Carone E, Morgan JA, Metra M, Dei Cas L. Left internal thoracic artery-radial artery composite grafts as the technique of choice for myocardial revascularization in elderly patients: a prospective randomized evaluation. J Thorac Cardiovasc Surg 2004;127(1):179-184
100. Takahashi K, Daitoku K, Nakata S, Oikawa S, Minakawa M, Kondo N. Early and mid-term outcome of anastomosis of gastroepiploic artery to left coronary artery. Ann Thorac Surg 2004;78(6): 2033-2036 Suma H, Tanabe H, Takahashi A, Horii T, Isomura T, Hirose H, Amano A. Twenty years experience with the gastroepiploic artery graft for CABG. Circulation 2007;116(11):I188-191
101. Balacumaraswami L, Abu-Omar Y, Selvanayagam J, Pigott D, Taggart DP. The effects of on-pump and offpump coronary artery bypass grafting on intraoperative graft flow in arterial and venous conduits defined by a flow/pressure ratio. J Thorac Cardiovasc Surg 2008;135(3):533-539