Mid Term Result In Endoscopically Versus Open Radial Artery Harvesting Technique A Randomised Trail
Muhammed Tamim, Sr.1, Yaser Al Kadi2, Donia AL Hassan1.
1King Fahd Military Medical Complex, Dhahran, Dhahran, Saudi Arabia, 2King Fahd Military Medical Complex, Dhahran, Saudi Arabia.
OBJECTIVE: Endoscopically harvested radial artery as a graft for coronary revascularization had become a standard of care in many centers; we introduced endoscopic harvesting technique since 4 years. The aim of this randomized study was to assess graft quality 1 year after the operation.
METHODS: We followed 30 patients who underwent non emergent on-pump coronary artery bypass grafting prospectively randomized to either endoscopic radial artery harvest (ERA) or open radial artery harvest (ORA) . Follow-up 64-slice cardiac computed tomography, echocardiography were utilized to assess graft patency and left ventricle function at a 6 months and 1-year follow-up. In addition, the influencing factors of radial artery graft patency were evaluated. One interventional cardiologists and consultant radiologist assigned graft patency and disease grades independently.
RESULTS: Any patency of endoscopically harvested radial artery grafts was 93% (28/30) and perfect patency was 83% (25/30) 1 year after coronary revascularization. The implanting surgeon and graft harvester, patient factors, graft properties, medication, and target territory did not influence the patency rates of the radial artery graft. The only significant and strong parameter to predict perfect graft patency was the severity of the target vessel stenosis (P < .001). Patency rates of endoscopically (82%) and conventionally (80%) harvested radial arteries were not different (P = .822).
CONCLUSIONS: Patency rates 1 year after endoscopic radial artery harvesting are comparable to the open technique. On the basis of our results, we attempt to use the radial artery as a bypass graft only for target coronary arteries with 90% or greater stenosis. We recommend endoscopic harvesting as the technique of choice to harvest the radial artery.
Back to 2017 Cardiac Track Overview