Routine myocardial revascularization with the radial artery: A multicenterexperience

Background: Current literature documents use of the radial artery (RA) for myocardial revascularization only as an alternative conduit in cases where the saphenous veins have been previously harvested or are unsuitable for us e. Large-scale routine clinical use of the RA as the conduit of choice has not been reported. Methods: This prospective study evaluated the harvest of the RA from 933 patients and the subsequent use of the conduit as a prefer red coronary artery bypass graft second only to the left internal thoracic artery in 930 of these patients. Results: Unilateral RA harvest was perform ed in 786 patients and 147 patients had bilateral RA harvest. A total of 10 80 RAs were harvested; 214 (19.8%) originated from the dominant forearm. Th ere was a mean of 3.30 +/- 0.93 grafts per patient of which 2.43 +/- 0.83 w ere arterial grafts. The mean number of RA grafts was 1.43 +/- 0.53. Operat ive mortality was 2.3% with none due to the RA graft(s). There was no ische mia nor motor dysfunction in the operated hands. Thirty-two (3.4%) patients experienced transient thenar dysesthesia that resolved in 1 day to 6 weeks . Conclusions: Our results demonstrate that routine total or near total art erial myocardial revascularization may be achieved safely and effectively w ith the use of one or both RAs in conjunction with the internal thoracic ar tery.