ĐÁNH GIÁ KẾT QUẢ PHẪU THUẬT BẮC CẦU ĐỘNG MẠCH VÀNH VỚI VẬT LIỆU CẦU NỐI TOÀN ĐỘNG MẠCH TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Background: Total Arterial Revascularization (TAR) in Coronary Artery Bypass Grafting (CABG) has demonstrated superior graft patency rates and improved survival compared to vein-based configurations. However, its application remains limited in Vietnam. Objective: To evaluate the clinical outcomes of total arterial CABG performed at Cho Ray Hospital. Material and Methods: A retrospective case series of 46 patients who underwent CABG using exclusively arterial conduits between January 2023 and May 2025 at Cho Ray Hospital. Patients receiving any saphenous vein grafts or undergoing concomitant cardiac procedures were excluded. Results: All patients received three or more separate arterial grafts, primarily using the left internal mammary artery (LIMA), right internal mammary artery (RIMA), and right gastroepiploic artery (RGEA). Off-pump CABG (OPCAB) was performed in 91.3% of cases. Postoperative outcomes were favorable: the mean ventilation time was 19.5 hours, and the average length of hospital stay was 9.5 days. The complication rate was low, with no in-hospital mortality. The anatomical characteristics of the conduits were suitable for the TAR strategy. Conclusions: Total arterial CABG is a feasible and safe strategy, associated with favorable early postoperative outcomes in the Vietnamese clinical setting. Further long-term studies are warranted to assess graft durability and survival outcomes.