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J Thorac Cardiovasc Surg 2005;130:9-12
© 2005 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Chronic compensatory increase in ulnar flow and accelerated atherosclerosis after radial artery removal for coronary artery bypass

^a Departments of Cardiac Surgery and Angiology, Rome, Italy
^b Catholic University, Rome, Italy.

Received for publication October 18, 2004; revisions received January 18, 2005; accepted for publication February 10, 2005.

^_* Address for reprints: Mario Gaudino, MD, Divisione di Cardiochirurgia, Policlinico Universitario, A. Gemelli, Largo A. Gemelli 8, 00168 Rome, Italy. (Email: mgaudino{at}tiscali.it).

BACKGROUND: Only scant information is available on the chronic consequences of radial artery removal for coronary artery bypass surgery on forearm circulation.

METHODS: Twenty-five patients submitted to radial artery removal for coronary artery bypass were submitted to serial Doppler echocardiographic evaluation of the flow and morphology of the forearm arteries.

RESULTS: The peak systolic velocity of the ulnar artery of the operated side was significantly higher than that of the control site. The intimal-medial thickness of the ulnar artery was always significantly higher on the operated side, and this difference reached statistical significance at 10 years’ follow-up. There was a significantly higher prevalence of atherosclerotic plaques in the ulnar artery of the operated versus control arm (7/25 vs 0/25, P = .03).

CONCLUSION: Radial artery removal for coronary artery bypass surgery leads to a chronic increase in ulnar flow accompanied by increased intimal-medial thickness and accelerated atherosclerotic disease. These findings might have potentially important implications for surgical indications and patient management.

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