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Artery over vein for diabetic heart surgery

November 21, 2014

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For diabetic patients requiring heart bypass surgery, the radial artery is a much better choice for bypass grafting than the saphenous vein.

A new study by a team in Sunnybrook’s Schulich Heart Centre, published in the Journal of Thoracic and Cardiovascular Surgery, found that five years or more after coronary artery bypass graft surgery (CABG), 25.3 per cent of diabetic patients receiving saphenous grafts from the leg or thigh had completely occluded, or blocked grafts, compared with 4.8 per cent who received a radial artery graft from the wrist or arm.

Bypass grafting is a surgical procedure to redirect blood flow around an area of blockage. The procedure creates an alternate channel for blood flow, bypassing an obstructed or damaged vessel.

“The results are resoundingly positive for choosing the radial artery over the saphenous vein when treating a diabetic patient,” says Dr. Saswata Deb, surgical fellow, Schulich Heart Centre.

“This is a significant result that we believe should and will impact the practice of cardiac surgeons around the world.”

heart-surgery

Full media release

For diabetic patients requiring heart bypass surgery, the radial artery is a much better choice for bypass grafting than the saphenous vein.

A new study by a team in Sunnybrook’s Schulich Heart Centre, published in the Journal of Thoracic and Cardiovascular Surgery, indicates that five years or more after coronary artery bypass graft surgery (CABG), 25.3 per cent of diabetic patients receiving saphenous grafts from the leg or thigh had completely occluded, or blocked grafts, compared with 4.8 per cent who received a radial artery graft from the wrist or arm.

Bypass grafting is a surgical procedure to redirect blood flow around an area of blockage. The procedure creates an alternate channel for blood flow, bypassing an obstructed or damaged vessel.

“The results are resoundingly positive for choosing the radial artery over the saphenous vein when treating a diabetic patient,” says Dr. Saswata Deb, surgical fellow, Schulich Heart Centre. “This is a significant result that we believe should and will impact the practice of cardiac surgeons around the world.”

The findings are part of the multi-centre Radial Artery Patency Study, looking at 529 patients aged less than 80 years with triple-vessel disease undergoing coronary bypass surgery. Each patient received angiography more than five years after surgery to assess the patency, or success, of the grafts. This study looked at a subgroup of 269 patients, 148 of which had diabetes. Graft patency between the radial artery and saphenous vein was not significantly different in the non-diabetic patient group.

“Diabetic patients are at a higher risk for severe heart disease and may develop the disease at a younger age,” says Dr. Stephen Fremes, professor at the University of Toronto and cardiac surgeon at the Schulich Heart Centre.

“A heart team approach should of course evaluate the complexity of each patient’s coronary artery disease. Our goal is to provide evidence-based recommendations for the treatment of diabetic patients so that they receive the most effective treatment.”

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