Palmar microcirculation after harvesting of the radial artery in coronary revascularization.
OBJECTIVE
To evaluate real-time parameters of palmar microcirculation before and after harvesting of the radial artery in coronary revascularization using a laser Doppler flowmetry and remission spectroscopy system (O2C).


METHODS
Fifteen patients (11 males, 54 +/- 4 years, mean New York Heart Association [NYHA] class of 2.3 +/- 0.3) were prospectively scheduled with control measurements of the fingertips of D1, D3, and D5 at base line, after suprasystolic, and after selective radial or ulnar compression for tissue oxygen saturation (SO2), postcapillary venous recombinant hemoglobin (rHb) concentration, superficial (2 mm) blood flow, and deep (8 mm) blood flow.


RESULTS
Preoperatively during suprasystolic compression SO2 decreased significantly for the fingertips of D1, D3, and D5 by -58%, -74%, and -63%, respectively (p < 0.05). Radial compression reduced SO2 for all fingertips (-12%, -14%, and -16%), as did ulnar compression (-24%, -18%, and -10%). rHb did not change significantly for either compression type. Superficial and deep blood flow decreased significantly after suprasystolic and only slightly after radial and ulnar compression at either side. No side differences were noted. After radial artery harvesting, microcirculatory parameters did not change considerably versus preoperatively.


CONCLUSIONS
Radial artery harvesting does not remarkably change microcirculatory parameters of the hand. The O2C system is a safe and quantitative method to assess both preoperatively and postoperatively the palmar microcirculation and therefore adds further functional clinical information.
Knobloch
Karsten
K
Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany. knobloch@thg.mh-hannover.de
Lichtenberg
Artur
A
Pichlmaier
Max
M
Tomaszek
Sandra
S
Krug
Alfons
A
Haverich
Axel
A
D001026:Coronary Artery Bypass; D005260:Female; D006225:Hand / Q000098:blood supply*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011446:Prospective Studies; D012039:Regional Blood Flow; D020858:Tissue and Organ Harvesting