The radial artery as a graft for myocardial revascularization was introduced by Carpentier in the early 1970s. Mid-term results were unfortunately discouraging, and the clinical experience with this graft was interrupted. At the end of the 1980s,
These
authors reproposed the same arterial conduit with more satisfying results, because of improved technique and pharmacological management of the graft. Between October 1994 and July 1995, 36 patients underwent myocardial revascularization with a
radial
artery graft in Sejong General Hospital. Left internal mammary artery was concomitantly used as a pedicled graft in 34 patients. Fifteen patients (42%) had a complete arterial graft revascularization. A total of 123 distal anastomoses were
performed
(average 3.4 per patients), including 36 left internal mammary artery grafts(two sequential in 2 patients), and 23 saphemous vein grafts. The remaining 64 distal anastomoses were performed with radial artery grafts(mean 1.8 per patient). The
radial
arteries were anastomosed to the circumflex(n=38), diagonal(n=18), right coronary(n=6), and left anterior descending coronary artery(n=2). The percentage of radial artery graft anastomoses(64) to the total anastomoses(123) was 52%. The radial
artery was
used as a single graft in 10 patients, as a sequential graft in 25 patients, and two grafts in 1 patient. Twenty patients underwent associated procedures : coronary endarterectomy(14), coronary artery patch angioplasty(4), mitral valve repair(1),
and
repair of ventricular septal rupture(1). One patient died of low cardiac output syndrome and the others had no perioperative myocardial infarction. There are no ischemic and functional complications in the arm or hand after removal of the radial
artery.
Only 1 patients required reexploration of the arm, for the hematoma evacuation, and 2 patients complained transient thumb dysesthesia of the side of the havested arm. This dysesthesia improved within one month. Postoperative angiographic controls
were
obtained in 11 patients(31%) postoperative 79 to 210 days (mean 126 days). The patency rate were as follow : left internal mammary artery(100%), saphenous vein (100%), and radial artery(95%). We concluded that the radial artery is useful
alternative
graft, but long term clinical and angiographic studies are required to dertermine whether wider application is warranted.
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