Patency rates of endoscopically harvested radial arteries one year after coronary artery bypass grafting.
OBJECTIVE
To improve patients' acceptance of the radial artery as a graft for coronary revascularization, we introduced an endoscopic harvesting technique. The aim of this study was to assess graft quality 1 year after the operation.


METHODS
In 50 patients who underwent endoscopic radial artery harvesting for coronary artery bypass grafting, 64-slice computed tomography, electrocardiography, and echocardiography were utilized to assess graft patency and left ventricle function at a 1-year follow-up. In addition, the influencing factors of radial artery graft patency were evaluated. Radial artery patency was compared with a control group from our database.


RESULTS
Any patency of endoscopically harvested radial artery grafts was 78% (39/50) and perfect patency was 72% (36/50) 1 year after coronary revascularization. The implanting surgeon and graft harvester, patient factors, graft properties, medication, and target territory did not influence the patency rates of the radial artery graft. The only significant and strong parameter to predict perfect graft patency was the severity of the target vessel stenosis (P < .001). In patients with a target vessel stenosis of 90% or greater, radial artery graft patency was 90.3% (28/31). Patency rates of endoscopically (72%) and conventionally (74%) harvested radial arteries were not different (P = .822).


CONCLUSIONS
Patency rates 1 year after endoscopic radial artery harvesting are comparable to the open technique. On the basis of our results, we attempt to use the radial artery as a bypass graft only for target coronary arteries with 90% or greater stenosis. We recommend endoscopic harvesting as the technique of choice to harvest the radial artery.
Bleiziffer
Sabine
S
Clinic for Cardiovascular Surgery, German Heart Center Munich, Munich, Germany. bleiziffer@dhm.mhn.de
Hettich
Ina
I
Eisenhauer
Birgit
B
Ruzicka
Daniel
D
Wottke
Michael
M
Hausleiter
Joerg
J
Martinoff
Stefan
S
Morgenstern
Martin
M
Lange
Ruediger
R
D001026:Coronary Artery Bypass; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000637:transplantation*; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014654:Vascular Patency