Complete arterial coronary artery bypass grafting versus conventional revascularization -: Early results

Background: Complete arterial coronary artery bypass grafting (CABG) offers the potential to improve long-term results. However, an increased perioperative risk has been controversially discussed. New operative techniques (skeletonization of the ITA/T-grafts/utilization of the radial artery (RA)) may decrease perioperative risk. We compared the outcome after conventional with that after complete arterial CABG. Material and Methods: Three consecutive groups of patients were analyzed. In group I (n=50), CABG was performed using left ITA and vein grafts. The other two groups received complete arterial CABG with either both ITA's (group II; n=52) or left ITA and RA (group III; n=52). Results: A mean of 3.9 +/- 0.8 (I) versus 4.2 +/- 0.8 (II) and 3.9 +/- 0.9 (III) anastomoses were performed per patient (ns). Mean operating time was significantly prolonged in group II (II: 252 +/- 54: p < 0.0001; vs. I: 191 +/- 36; III: 203 +/- 33). Mean ischemic time was significantly prolonged in group II and III (II: 65 +/- 20; p < 0.0001; III: 68 +/- 16; p < 0.0001; vs. I: 51 +/- 15). Mean bypass time (I: 83 +/- 23; II: 95 +/- 41; III: 91 +/- 21), the rate of postoperative complications and in-hospital mortality (I: n=0; II: n=2; III: n=0; ns) showed no significant differences. Conclusions: Complete arterial CABG using modern surgical techniques is as safe as the conventional surgical approach using left ITA and vein graft.