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J Thorac Cardiovasc Surg 2007;134:649-656
© 2007 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Patency rates of endoscopically harvested radial arteries one year after coronary artery bypass grafting

^a Clinic for Cardiovascular Surgery, German Heart Center Munich, Munich, Germany
^b Clinic for Cardiology, German Heart Center Munich, Munich, Germany
^c Institute for Radiology, German Heart Center Munich, Munich, Germany
^d Department for Internal Medicine I, Clinical Center Rosenheim, Munich, Germany.

Received for publication September 21, 2006; revisions received April 2, 2007; accepted for publication April 11, 2007.

^_* Address for reprints: Sabine Bleiziffer, MD, Clinic for Cardiovascular Surgery, German Heart Center Munich, Lazarettstr. 36, 80636 Munich, Germany. (Email: bleiziffer{at}dhm.mhn.de).

Objectives: To improve patients’ acceptance of the radial artery as a graft for coronary revascularization, we introduced an endoscopic harvesting technique. The aim of this study was to assess graft quality 1 year after the operation.

Methods: In 50 patients who underwent endoscopic radial artery harvesting for coronary artery bypass grafting, 64-slice computed tomography, electrocardiography, and echocardiography were utilized to assess graft patency and left ventricle function at a 1-year follow-up. In addition, the influencing factors of radial artery graft patency were evaluated. Radial artery patency was compared with a control group from our database.

Results: Any patency of endoscopically harvested radial artery grafts was 78% (39/50) and perfect patency was 72% (36/50) 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). In patients with a target vessel stenosis of 90% or greater, radial artery graft patency was 90.3% (28/31). Patency rates of endoscopically (72%) and conventionally (74%) 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.

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