Routine Use of Unilateral and Bilateral Radial Arteries for Coronary Artery Bypass Graft Surgery

• Published in: Journal of the American College of Cardiology Vol. 28; no. 4; pp. 959 - 963
• Main Authors: BRODMAN, RICHARD F, FRAME, ROSEMARY, CAMACHO, MARGARITA, CHEN, ALAN, HU, ERIC, HOLLINGER, INGRID
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.1996; Elsevier Science
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Child; Child, Preschool; Coronary Artery Bypass - methods; Coronary Disease - surgery; Female; Humans; Infant; Male; Medical sciences; Middle Aged; Prospective Studies; Radial Artery - transplantation; Saphenous Vein - transplantation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Treatment Outcome; Vascular Patency; Human; Treatment; Aortocoronary; Bypass; Surgery; Homograft; Graft; Bilateral; Technique; Radial artery
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(96)00265-3

Objectives. This study sought to evaluate the routine use of radial artery (RA) grafts in patients undergoing coronary artery revascularization. Background. Previous long-term studies have documented poor patency of saphenous vein grafts compared with internal thoracic artery (ITA) grafts. Methods. We performed a prospective review of 175 of 249 consecutive patients. Results. Fifty-four patients had bilateral RAs harvested. Mean number (±SD) of grafts/patient was 3.27 ± 0.93, with 2.76 ± 0.97 arterial grafts; a mean of 1.53 ± 0.68 grafts were performed with the RA. The operative mortality rate was 1.6%. No deaths were related to RA grafts, and there were no RA harvest site hematomas or infections. Transient dysesthesia 1 day to 4 weeks in duration occurred in the distribution of the lateral antebrachial cutaneous nerve in six extremities (2.6%). Elective cardiac catheterization in 60 patients at 12 weeks postoperatively demonstrated a 95.7% patency rate. Conclusions. Because of potential benefit of long-term patency associated with arterial grafts, minimal morbidity and mortality associated with use of the RA and excellent short-term patency rates, we cautiously recommend use of one or both RAs as additional conduits to be used concomitantly with the ITA for arterial revascularization of the coronary arteries.