Objective: To review the experience coronary artery bypass grafting (CABG) with the radial artery (RA) performed from June 1997 to December 1999.
Methods: A total of 71 patients received CABG in whom the performance of the radial and ulnar arteries were checked preoperatively with the modified Allen's test. A curvilinear skin incision was made from 3 cm distal to the cubital fossa to 2 cm before the proximal crease at the wrist. The RA was mobilized together with its satellite veins and surrounding fat tissues. Small branches were divided between titanium clips. Direct touching on the RA trunk was totally avoided and use of diathermy was minimized. A 1% papaverine solution of heparinized Ringer's was applied intraluminally into the free RA graft before it was stored in the same solution for later use. Seventy-two RAs were harvested and 79 distal anastomoses were made mostly to the posterior descending branches and the circumflex marginal branches. All the proximal anastomoses were directed to the aorta. Calcium channel blockers were routinely used for a period of 6 months postoperatively.
Results: There was 1 death for an operative mortality of 1.4%. The death was not caused by failure of RA graft. There was no compartment syndrome or hand ischemia. No perioperative myocardial infarction was observed.
Conclusions: It is easy and safe to use the RA for CABG by which good results can be achieved. A'no-touch' harvesting technique and use of calcium-channel blockers are essential to the functioning of this conduit.