Routine myocardial revascularization with the radial artery: a multicenter experience

Area of Science:

• Cardiovascular Surgery
• Vascular Grafting
• Myocardial Revascularization

Background:

• The radial artery (RA) is typically an alternative conduit for myocardial revascularization.
• Large-scale routine use of the RA as a primary graft has not been documented.

Purpose of the Study:

• To evaluate the safety and efficacy of routine use of the radial artery as a preferred graft in myocardial revascularization.
• To assess the feasibility of achieving total or near-total arterial grafting using the RA.

Main Methods:

• Prospective evaluation of radial artery harvest in 933 patients.
• Subsequent use of the radial artery as a preferred coronary artery bypass graft in 930 patients.
• Data collection on graft numbers, operative mortality, and limb function.

Main Results:

• 1080 radial arteries were harvested, with a mean of 1.43 RA grafts per patient.
• Operative mortality was 2.3%, with no deaths attributed to the RA graft.
• No ischemia or motor dysfunction was observed in operated hands; 3.4% experienced transient dysesthesia.

Conclusions:

• Routine total or near-total arterial myocardial revascularization is safe and effective using the radial artery.
• The radial artery can be used routinely as a preferred graft alongside the internal thoracic artery.
• This approach facilitates comprehensive arterial grafting in coronary artery bypass surgery.