title: Venous reconstruction with radial artery harvesting: Domino method.
abstract: We describe two cases of venous reconstruction after radial artery (RA) harvesting for coronary artery bypass grafting (CABG). Patient 1, a 70-year-old man who underwent CABG 16 years earlier, presented with acute posterolateral myocardial infarction caused by total occlusion of the saphenous vein graft (SVG). RA grafting was considered ideal, but he had bilateral hypoplastic ulnar arteries. Venous reconstruction with RA harvesting using SVG was performed, and surgery was successful. Patient 2, a 57-year-old-man with chronic renal failure caused by polycystic kidney disease, presented with angina pectoris. Off-pump CABG was recommended. We used a right internal thoracic artery and the RA as an I-composite graft. However, RA preservation was essential for future hemodialysis. The RA was harvested and reconstructed as described for patient 1. Ischemia had not developed in the hands and forearms as of 5 years after the surgery. We believe that the method may be an alternative graft choice in CABG.
authors.affiliation: Department of Cardiovascular Surgery, Cardiovascular Center, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan. kyky-tanaka@mvc.biglobe.ne.jp
authors.forename: Keita
authors.initials: K
authors.lastname: Tanaka
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Naruse
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D047549:Coronary Artery Bypass, Off-Pump; D054059:Coronary Occlusion / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000601:surgery; D017534:Radial Artery / Q000637:transplantation*; D012086:Reoperation; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000637:transplantation*; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome