ROUTINE USE OF UNILATERAL AND BILATERAL RADIAL ARTERIES FOR CORONARY-ARTERY BYPASS GRAFT-SURGERY

Objectives. This study sought to evaluate the routine use of radial ar tery (RA) grafts in patients undergoing coronary artery revascularizat ion. Background. Previous long-term studies have documented poor paten cy of saphenous vein grafts compared with internal thoracic artery (IT A) grafts. Methods. We performed a prospective review of 175 of 249 co nsecutive patients. Results. Fifty four patients had bilateral RAs har vested. Mean number (+/-SD) of grafts/patient was 3.27 +/- 0.93, with 2.76 +/- 0.97 arterial grafts; a mean of 1.53 +/- 0.68 grafts were per formed with the RA. The operative mortality rate was 1.6%. No deaths w ere related to RA grafts, and there were no RA harvest site hematomas or infections. Transient dysesthesia 1 day to 4 weeks in duration occu rred in the distribution of the lateral antebrachial cutaneous nerve i n six extremities (2.6%). Elective cardiac catheterization in 60 patie nts at 12 weeks postoperatively demonstrated a 95.7% patency rate. Con clusions. Because of potential benefit of long term patency associated with arterial grafts, minimal morbidity and mortality associated with use of the RA and excellent short-term patency rates, we cautiously r ecommend use of one or both RAs as additional conduits to be used conc omitantly with the ITA for arterial revascularization of the coronary arteries.