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 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; mean of 1.53 ± 0.68 grafts were performed with the RA. The operative mortality rate was 1.6%. No deaths were related to R grafts, and there were no R harvest site hematomas or infections. Transient dysesthesi 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 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 R and excellent short-term patency rates, we cautiously recommend use of one or both RAs as additional conduits to be used concomitantly with the IT for arterial revascularization of the coronary arteries.