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Endoscopic radial artery harvesting for coronary artery bypass grafting. A single center evolving experience
Martin Simek1, Pavel Marcian, Marek Gwozdziewicz
1Department of Cardiac Surgery, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
Aim:
We sought to evaluate our experience with endoscopic radial artery harvesting for coronary artery bypass grafting (CABG).
Methods:
From October 2005 to June 2010, 50 patients who underwent endoscopic radial artery harvesting for an elective CABG were prospectively assessed for harvesting characteristics, complications, postoperative and mid-term outcomes.
Results:
There were 34 (68%) males and 16 (32%) females, average age 60.8 ± 9.2 years. All but two RA grafts (96%) were successfully harvested endoscopically. Mean harvesting time was 46.2 ± 9.3 min and mean length of harvested grafts was 23.4 ± 2.2 cm. In the post-operative period there were no wound-healing complications; residual forearm edema was recorded in 6 patients (12%) and peripheral neuropathy in 4 patients (8%). At 3 months after the surgery, peripheral neuropathy and residual edema persisted in 2 patients (4%). A significant drop of overall harvesting time (56.2 ± 18.6 vs. 38.6 ± 8.6 min, P<0.05) and forearm ischemia time (41.8 ± 12.7 vs. 24.2 ± 3.2 min, P<0.01) was found between first and last ten cases in the group.
Conclusion:
Endoscopic radial artery harvesting was associated with low risk of post-harvesting complications and most of these disappeared within a 3 months follow-up. However, there was a significant learning curve.
