• Yunpeng Zhu, Anqing Chen, Zhe Wang, Jun Liu, Junfeng Cai, Mi Zhou, and Qiang Zhao.
• Department of Cardiac Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
• Interact Cardiovasc Thorac Surg. 2017 Oct 1; 25 (4): 559-564.

ObjectivesLong-term effectiveness of coronary artery bypass grafting using radial artery (RA) or great saphenous vein (SVG) grafts as a second conduit was compared.MethodsPatients received simple elective off-pump coronary artery bypass involving both the left internal thoracic artery (LITA) and the left anterior descending artery between January 1999 and December 2005 at Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China. RA graft patients (n = 147 LITA + RA and n = 61 LITA + RA + SVG) were matched with SVG graft patients (n = 208 LITA + SVG). Mean follow-up was 86.5 months.ResultsBaseline characteristics were comparable before and after surgery. Intraoperative hospital mortality was not significantly different. In all, 378 (90.9%) patients completed postoperative follow-up (197 in the RA and 181 in SVG). Overall survival was significantly better in the RA group (Log-rank, P = 0.017) with 88% 10-year survival in the RA group and 81% in the SVG group. All-cause mortality was significantly lower in the RA group (hazard ratio 0.42, 95% confidence interval 0.20-0.88, P = 0.020). Major adverse cardiovascular event-free survival was significantly better in the RA group than in the SVG group (Log-rank, P = 0.019). No significant difference in the length of postoperative angina relief was found.ConclusionsUsing the RA as the secondary graft for coronary artery bypass grafting improved long-term postoperative survival and reduced the incidence of postoperative major adverse cardiovascular events.© The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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