Endoscopic Radial Artery Harvesting for Coronary Artery Bypass Grafting: First Experience

Overview

Background:
Radial artery is widely accepted for surgical myocardial revascularization due to reported better long-term patency than venous grafts. Endoscopic radial artery harvesting (ERAH) represents a modern method associated with reduction of post-harvesting complications in comparison with the traditional radial artery harvesting.

Methods:
From October 2005 to March 2006, ERAH was performed in a group of 10 patients employing the Vasoview 6™ system (Guidant, Europe S.A., Belgium). Patients were evaluated on 7th postoperative day for wound healing disturbances and neurological complications.

Results:
The mean age was 62.7 ± 11.3 years, male patients dominated (60%) and 5 patients (50%) suffered from diabetes. All 10 radial arteries were successfully harvested, no conduit was injured. No conversions were made from ERAH to traditional technique. The mean harvesting time was 44.9 ± 8.2 min (range: 32–62) and the mean time of forearm ischemia was 56.7 ± 9.3 min (range: 42–74). The mean length of the grafts was 20.3 ± 2.2 cm. The small local haematoma was recorded in one patient (10%). Neither wound disturbances such as wound infection, wound dehiscence, skin necrosis, nor neurological complications were recorded in our group of patients.

Conclusion:
ERAH is a safe method associated with a significant reduction of particularly neurological complications associated with traditional radial artery harvest. Full-length radial artery conduits were obtained with improved cosmetic result and patient’s satisfaction.