Functional status of the hand after radial artery harvesting: results in 3,977 cases.
BACKGROUND
The radial artery is being used as a conduit of choice over saphenous vein with increasing frequency. We analyzed early and midterm results of coronary artery bypass grafting using radial artery as one of the conduits. The functional outcome of the hand after radial artery harvesting was analyzed.


METHODS
The radial artery was used in 3,977 patients undergoing coronary artery bypass grafting between December 1996 and November 2000. Modified Allen's test was performed preoperatively in the ward and pulse oxymetry was used in the operating theater to assess the collateral circulation of the hand. A total of 4,172 anastomoses were performed using a radial artery. The patients were followed up at regular intervals in the outpatient clinic or were sent questionnaires. The functional results of the hand were assessed. Follow-up angiography was performed in 104 patients at a mean of 18 months.


RESULTS
The hospital mortality was 0.8%. Perioperative myocardial infarction occurred in 1.3% of patients. The average number of grafts was 3.12. No patient had acute ischemic injury of the hand. Follow-up was complete in 94% of patients. Late infection developed in 0.4% of patients. Numbness and paresthesias continued in 6.5% and 3% patients, respectively, after 3 months. The patency rate of the radial and left internal mammary artery was 92.3% and 96.0%, respectively, at a mean of 18 months.


CONCLUSIONS
Use of radial artery for coronary artery bypass grafting is associated with low morbidity and good functional outcome of the hand. It can be used more frequently as the conduit of choice after the internal mammary artery.
Meharwal
Z S
ZS
Escorts Heart Institute and Research Centre, New Delhi, India. meharwal@hotmail.com
Trehan
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000098:blood supply* / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000637:transplantation*; D011859:Radiography; D013997:Time Factors