Technical Aspects of the Use of the Radial Artery in Coronary Artery Bypass Surgery.


Journal

The Annals of thoracic surgery
ISSN: 1552-6259
Titre abrégé: Ann Thorac Surg
Pays: Netherlands
ID NLM: 15030100R

Informations de publication

Date de publication:
08 2019
Historique:
received: 18 07 2018
revised: 14 09 2018
accepted: 23 10 2018
pubmed: 16 12 2018
medline: 22 11 2019
entrez: 16 12 2018
Statut: ppublish

Résumé

The radial artery has been used for coronary artery bypass surgery for more than 25 years. The recent confirmation of the clinical benefits associated with the use of the artery is likely to drive a new interest toward this conduit in the next few years. A group of surgeons with extensive experience in the systematic use of the radial artery summarize here the key technical aspects of the use of the conduit for coronary bypass operations. Preoperative evaluation of the ulnar collateral circulation and attention to the characteristics of the target vessel are keys for the successful use of the radial artery. Open or endoscopic harvesting can be used, preferentially with the aid of the harmonic scalpel. The use of vasodilatory and antispastic protocols is probably important but poorly supported by the current evidence. The radial artery can be used for multiple grafting strategies with a variable degree of technical complexity. With attention to few technical key points, the radial artery is a versatile conduit that can be easily introduced in the everyday practice of coronary artery bypass surgery.

Sections du résumé

BACKGROUND
The radial artery has been used for coronary artery bypass surgery for more than 25 years. The recent confirmation of the clinical benefits associated with the use of the artery is likely to drive a new interest toward this conduit in the next few years.
METHODS
A group of surgeons with extensive experience in the systematic use of the radial artery summarize here the key technical aspects of the use of the conduit for coronary bypass operations.
RESULTS
Preoperative evaluation of the ulnar collateral circulation and attention to the characteristics of the target vessel are keys for the successful use of the radial artery. Open or endoscopic harvesting can be used, preferentially with the aid of the harmonic scalpel. The use of vasodilatory and antispastic protocols is probably important but poorly supported by the current evidence. The radial artery can be used for multiple grafting strategies with a variable degree of technical complexity.
CONCLUSIONS
With attention to few technical key points, the radial artery is a versatile conduit that can be easily introduced in the everyday practice of coronary artery bypass surgery.

Identifiants

pubmed: 30552888
pii: S0003-4975(18)31785-5
doi: 10.1016/j.athoracsur.2018.10.066
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

613-622

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Auteurs

Mario Gaudino (M)

Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York. Electronic address: mfg9004@med.cornell.edu.

Stephen Fremes (S)

Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.

Thomas A Schwann (TA)

Department of Cardiothoracic Surgery, University of Toledo, Toledo, Ohio; Department of Cardiothoracic Surgery, University of Massachusetts - Baystate, Springfield, Massachusetts.

James Tatoulis (J)

Department of Cardiothoracic Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia.

Matthew Wingo (M)

Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York.

Robert F Tranbaugh (RF)

Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York.

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Classifications MeSH