Abstract
Coronary artery stenosis bypass by using radial artery is good techniques which have longer outcomes. In coronary artery bypass grafting (CABG) the radial artery has several advantages. The radial artery has a thick muscular wall which is more susceptible to contraction from the competitive flow. As compared to the open harvesting technique endoscopic harvest of the radial artery has long lasting cosmetic results it also reduces the post-operative complications. The purpose of the study is to compare the two harvesting techniques and compare the short term and long term results related to intra-operative and post-operative outcomes Methods: This is retrospective study (In Queen Alia Heart Institute, Amman ,Jordan) to compare endoscopic radial artery technique versus open technique by reviewing patients files through a period between June 2013 and June 2018. Total 50 patients of CABG surgery was selected they were divided into two groups. Group A includes endoscopic radial harvest (n= 10) and Group B includes open harvest (n=40). Data was collected on predesigned Performa. Data were entered and analyze through IBM SPSS 22.0 Results: There was insignificant dissimilarity between the pre-operative outcomes between groups. The Post-operative outcomes were almost same in both groups except hand numbness (P-value<0.005). The comparison of intraoperative outcomes like harvest time between both groups indicate that the mean harvest time in group A was shorter than group B (39.20 + 3.73 Vs 51.90 + 2.09, P-value=0.000). The operative time in group A was higher than the group B (306.0 + 11.6 Vs 278 + 4.25 p-value=0.00). The hospital stays in both groups were insignificantly different (p = 0.09) Conclusions: Endoscopic radial artery harvest is best suited technique for CABG surgery as it significantly decreases the harvest time as well as hospital stay. It is also proven that it is safer, less painful and better wound appearance technique with exceptional outcomes based on positive surgical experience.
Highlights
In young patients coronary artery stenosis bypass by using radial artery is a good technique which have longer outcomes [1, 2]
This technique got popularity in the year 2005, in harvesting the saphenous and radial artery it was used over a large scale and in USA hospitals about 80% of coronary artery bypass grafting (CABG) patients have endoscopically harvested both radial artery and saphenous vein [7]
The (Vasoview Endscopic Vessel Harvesting System MAQUET cardiovascular santa clara, CA) was used for endoscopic harvesting. at the beginning we evaluate the pulsation in nondominant hand by using Allens test as well as around 2 cm incision had been done in the flexor part of the hand immediately over the radial artery near to the distal part of forearm we had used electrocautery by using camera for guiding to direct exposure of the artery with using CO2 inflation under pressure of 10 mmHg
Summary
In young patients coronary artery stenosis bypass by using radial artery is a good technique which have longer outcomes [1, 2]. The patients who were obese, diabetic and have chronic pulmonary disease where the sternal infection rate was increased due to bilateral harvesting of the internal mammary arteries, as substitute to the right internal mammary artery (RIMA) the radial artery can be used. It produces effective results [3]. Later on in 2001, this technique was imply for the radial artery harvesting This technique got popularity in the year 2005, in harvesting the saphenous and radial artery it was used over a large scale and in USA hospitals about 80% of CABG patients have endoscopically harvested both radial artery and saphenous vein [7]
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