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J Thorac Cardiovasc Surg 2002;123:512-516
© 2002 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease (ACD)

Effect of radial artery harvest on collateral forearm blood flow and digital perfusion

From the Department of Cardiothorcic Surgery, Joan and Sanford I. Weill Medical College of Cornell University, New York– Presbyterian Hospital, New York, NY.

Received for publication May 17, 2001; revisions requested July 13, 2001; revisions received July 18, 2001; accepted for publication July 24, 2001. Address for reprints: Richard Brodman, MD, Department of Cardiothoracic Surgery, Weill Medical College, 525 East 68th St, New York, NY 10021 (E-mail: rfb20002{at}mail.med cornell.edu).

Background: Changes describing digital and forearm circulation after radial artery harvest have been reported infrequently.
Methods: This prospective study examined digital perfusion and forearm collateral circulation preoperatively and postoperatively in patients who underwent coronary artery bypass grafting with radial artery free grafts. Noninvasive evaluation was conducted with digital photoelectric plethysmography and color flow and pulsed Doppler studies.
Results: Thumb perfusion index decreased from 1.25 to 0.84 (30%, P < .001) in the unoperated extremities and from 1.23 to 0.80 (36%) in the operated extremities (P < .001). Doppler studies in extremities after radial artery harvest demonstrated an increase in ulnar artery diameter from 3.87 to 4.66 mm (15.7%, P < .001) and a rise in ulnar blood flow velocity from 38.96 to 48.46 cm/s (17.4%) preoperatively to 8 weeks postoperatively (P < .001). No hand ischemia was noted.
Conclusions: Our study identified a mild reduction in digital perfusion and an increase in ulnar artery flow velocity and diameter with no clinical sequelae or compromise in hand function after radial artery harvest in properly selected patients.

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