Harvesting of the Radial Artery for Coronary Artery Bypass Grafting: Comparison of Ultrasonic Harmonic Scalpel Dissector with the Conventional Technique

Abstract

Use of the radial artery for coronary artery bypass grafting is getting more popular. We started routine use of the ultrasonic dissecting scalpel in harvesting radial arteries aiming to minimize harvesting time, improve graft quality, and reduce wound complications. Radial artery harvesting technique using harmonic scalpel (HS; 43 patients) was compared with the conventional technique (Hemostatic clips and scissors; 53 patients). To avoid spasm, the radial artery was not skeletonized and papaverine was used to irrigate radial artery routinely in all patients. Compared to the conventional technique, radial artery harvesting using the HS has a significantly shorter harvesting time (25 minutes vs. 50 minutes, p < 0.001) and required a significantly smaller number of hemostatic clips (3 vs. 40, p < 0.001). In situ free blood flow was significantly higher in HS group (80 mL/min vs. 40 mL/min, p < 0.001). There was no forearm wound infection in the HS group. There was no graft failure, reoperation for bleeding, or hand ischemia with the use of either technique. Harvesting the radial artery using the HS is less time consuming and decreased the use of hemostatic clips rather atraumatic with good quality graft.