Abstract
We sought to evaluate our experience with endoscopic radial artery harvesting for coronary artery bypass grafting (CABG). 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. 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. 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.
Highlights
Radial artery (RA) has been widely adopted for coronary artery bypass grafting since the mid-1990s when interest in this practise was renewed[1]
The risk of severe post-harvesting complications leading to hand disability as a consequence of hand ischemia or major neuronal trauma is extremely rare if the surgical technique and pre-operative hand collateral blood flow evaluation are carried out properly[2,7,12]
Our results showed a significant learning curve of endoscopic radial artery harvesting (ERAH) even with ample previous experience using endoscopic vein harvesting techniques
Summary
Radial artery (RA) has been widely adopted for coronary artery bypass grafting since the mid-1990s when interest in this practise was renewed[1]. Follow-up All data were collected prospectively, including demographic, operative, procedural characteristics (harvesting time, length of graft) and procedural complications (conversion rate, bleeding, blood loss and graft injury rate). Post-harvesting surgical complications including hematomas, residual forearm edema, pain, and woundhealing disturbances, hand ischemia, and neurological disturbances including sensory (numbness or parenthesis) or motor impairment (hand grip test) was followed up to the 5th postoperative day, and at 3 months after the surgery.
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