Outcomes of Radial Artery Grafts Without Postoperative Calcium Channel Blocker Administration

Background: Guidelines encourage oral pharmacologic antispasmodic therapy for patients receiving a radial artery conduit during coronary artery bypass grafting. We review our experience with radial artery conduits without the postoperative use of calcium channel blocker therapy. Methods: A single-center, retrospective review patients undergoing isolated coronary artery bypass grafting with at least one radial artery conduit over a three-year period was performed. Patient demographic, operative, and post-discharge data were collected. Development of angina or angina equivalent symptoms, imaging suggestive of radial conduit failure, or percutaneous intervention to the territory grafted by a radial artery was considered to represent graft failure. Patients were evaluated for primary outcomes through 90 days postoperatively and followed for 1 year overall. Results: 264 adult patients underwent first-time, isolated coronary artery bypass grafting with use of a radial artery conduit. Three patients were observed to have radial graft occlusions during the first 90 days, all of which were attributed to technical issues. No patients required addition of a calcium channel blocker & no additional patients underwent imaging or intervention for radial graft failure during 1 year of follow up. Conclusions: Avoidance of postoperative calcium channel blocker therapy in patients receiving a radial artery graft was not associated with a high incidence of imaging-confirmed or clinically suggested conduit failure.