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J Thorac Cardiovasc Surg 2005;129:250-253
© 2005 The American Association for Thoracic Surgery
Editorials |
Department of Cardiothoracic Surgery, John Radcliffe Hospital, Oxford, United Kingdom
Received for publication June 27, 2004; revisions received July 23, 2004; accepted for publication July 28, 2004. * Address for reprints: David P. Taggart, MD(Hons), PhD, FRCS, Professor of Cardiovascular Surgery, University of Oxford, and Consultant Cardiothoracic Surgeon, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK (E-mail: david.taggart@orh.nhs.uk).
| The first 300 words of the full text of this article appear below. |
Total arterial revascularization offers the potential to avoid the problems associated with vein graft failure. Bilateral internal thoracic arteries (ITAs) are the conduits of first choice because of excellent short- and long-term patency and the possibility of improved survival.1 The radial artery (RA) is easily harvested, versatile, has excellent handling characteristics, and has become the arterial conduit of third choice.2 Issues remain concerning its optimal use, however, particularly with reference to preoperative assessment, harvesting techniques, vasospasm prophylaxis, grafting strategy, and long-term patency. This article critically examines the current evidence for these important aspects of RA use.
| Preoperative assessment |
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Concern about the reliability of the Allen test has prompted evaluation of other assessment techniques, such as digital pulse oximetry, digital plethysmography, and Doppler ultrasonographic methods. However, there is no convincing evidence that these result in improved clinical outcomes after RA harvest.
| Harvesting technique |
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