Vascular reactivity and flow characteristics of radial artery and long saphenous vein coronary bypass grafts: a 5-year follow-up

Radial artery (RA) aortocoronary bypass grafts anastomosed to a branch of the circumflex coronary artery have significantly better patency rates than saphenous vein (SV) grafts at 5 years, but the physiological characteristics and mechanisms involved are not clearly defined. We compared RA and SV gr...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2010-08, Vol.122 (9), p.861-867
Main Authors: Webb, Carolyn M, Moat, Neil E, Chong, Chee F, Collins, Peter
Format: Article
Language:English
Subjects:
Adenosine
Blood Flow Velocity - drug effects
Blood Flow Velocity - physiology
Coronary Angiography
Coronary Artery Bypass - methods
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - surgery
Endothelium, Vascular - physiology
Follow-Up Studies
Humans
Isosorbide Dinitrate
Radial Artery - transplantation
Saphenous Vein - transplantation
Time Factors
Ultrasonography, Interventional
Vascular Patency - drug effects
Vascular Patency - physiology
Vascular Resistance - drug effects
Vascular Resistance - physiology
Vasodilation - drug effects
Vasodilator Agents
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Summary:Radial artery (RA) aortocoronary bypass grafts anastomosed to a branch of the circumflex coronary artery have significantly better patency rates than saphenous vein (SV) grafts at 5 years, but the physiological characteristics and mechanisms involved are not clearly defined. We compared RA and SV graft vasomotor and flow responses to endothelium-dependent and -independent stimuli 5 years after surgery in a subgroup of patients enrolled in the Radial artery versus Saphenous Vein Patency (RSVP) trial. Twenty-seven patients were included in the study (RA, n=15; SV, n=12). Graft blood flow was calculated from flow velocity, measured by intracoronary Doppler, and luminal diameter, measured by quantitative coronary angiography, before and after intragraft infusions of adenosine, acetylcholine, and isosorbide dinitrate. At rest, RA luminal diameters were significantly smaller than SV luminal diameters (P=0.029), blood flow velocity was greater in RA than SV (P=0.008), and volume blood flows were similar. RA but not SV dilated in response to adenosine and isosorbide dinitrate (all P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.109.887000