Saphenous vein graft vs. radial artery graft searching for the best second coronary artery bypass graft

Coronary artery bypass grafting (CABG) was first used in the late 1960s. This revolutionary procedure created hope among ischemic heart disease patients. Multiple conduits are used and the golden standard is the left internal mammary artery to the left anterior descending artery. Although all approaches were advocated by doctors, the use of saphenous vein grafts became the leading approach used by the majority of cardiac surgeons in the 1970s. The radial artery graft was introduced at the same time but was not as prevalent due to complications. It was reintroduced into clinical practice in 1989. The procedure was not well received initially but it has since shown superiority in patency as well as long-term survival after CABG. This review provides a summary of characteristics, technical features and patency rates of the radial artery graft in comparison with venous conduits. Current studies and research into radial artery grafts and saphenous vein grafts for CABG are explored. However, more studies are required to verify the various findings of the positive effects of coronary artery bypass grafting with the help of radial arteries on mortality and long-lasting patency.

Traumatic dehiscence of Medtronic Freestyle stentless bioprosthesis

We report a case of deceleration injury causing traumatic dehiscence of a Medtronic Freestyle aortic bioprosthesis (Medtronic Inc, Minneapolis, MN) in a 70-year-old patient 5 years after a total root reconstruction. The patient presented with progressive exertional dyspnea 6 months after a significant impact during a hockey game. Intraoperatively, there was a posterior dehiscence of the proximal suture line and almost complete tear of the left coronary leaflet. At reoperation, the patient underwent reconstruction of the aortic root and Bentall procedure with a size 23 mechanical aortic valved conduit.