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 artery (RA) grafts in patients undergoing coronary artery revascularization. Background. Previous long-term studies have documented poor patency of saphenous vein grafts compared with internal thoracic artery (ITA) grafts. Methods. We performed a prospective review of 175 of 249 consecutive patients. Results. Fifty four patients had bilateral RAs harvested. 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 performed with the RA. The operative mortality rate was 1.6%. No deaths were related to RA grafts, and there were no RA harvest site hematomas or infections. Transient dysesthesia 1 day to 4 weeks in duration occurred in the distribution of the lateral antebrachial cutaneous nerve in six extremities (2.6%). Elective cardiac catheterization in 60 patients at 12 weeks postoperatively demonstrated a 95.7% patency rate. Conclusions. 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 recommend use of one or both RAs as additional conduits to be used concomitantly with the ITA for arterial revascularization of the coronary arteries.