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Innovations (Phila). 2013 Nov-Dec;8(6):398-402. doi: 10.1097/IMI.0000000000000027.

Results of endoscopic radial artery harvesting in 1577 patients.

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  • 1From the Division of Cardiothoracic Surgery, Beth Israel Medical Center, New York, NY USA.

Abstract

OBJECTIVE:

We reviewed 1577 consecutive patients undergoing coronary artery bypass grafting (CABG) using endoscopic harvesting of the radial artery (RA) to define our current results.

METHODS:

Since 2000, we have performed endoscopic RA harvest on 1577 consecutive patients; 1476 patients had isolated CABG, and 101 patients had CABG and other procedures. The mean ± SD age was 59.4 ± 9.0 years; 80.2% were men and 40% had diabetes mellitus. All data were prospectively collected. All-cause mortality was determined using the Social Security Death Index.

RESULTS:

There were nine in-hospital or 30-day deaths, for an operative mortality of 0.57%: mortality was 0.34% in isolated CABG and 3.85% in CABG/combined procedures. The overall estimated Kaplan-Meier survival at 1, 5, and 10 years was 99%, 95%, and 88%. In 37 patients, the RAs were not harvested or were not used for grafting because of a positive Allen test, extensive calcification or dissection, intramural hematoma, and scarring from previous arterial lines or catheterization. During postoperative follow-up, five patients (0.32%) were treated for incisional infection, and there were no ischemic hand complications. Three patients had a perioperative myocardial infarction in the RA graft distribution, and 15 patients had a coronary artery reintervention in the RA graft distribution. Two other patients had a percutaneous coronary intervention of their RAs. The overall RA patency at 10 years was 82%.

CONCLUSIONS:

Endoscopic harvest of the RA is an excellent minimally invasive conduit harvesting technique with minimal morbidity.

[PubMed - indexed for MEDLINE]
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