TITLE:
Endoscopic Radial Artery Harvest in Coronary Artery Bypass Surgery: Clinicopathological Evaluation
AUTHORS:
Amir Mohamed, Kamelia Velikova, Ahmed Nabil, Amr Algarhy, Mohamed Badawy, Adel Maher, Ashraf Abdelsalam, Jamal Al-Fadhli, Riyad Tarazi, Nael Al-Sarraf
KEYWORDS:
Radial Artery, Endoscopic Harvest, Coronary Artery Bypass, Histology
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.9 No.2,
February
15,
2019
ABSTRACT: Objectives: The radial artery is used as a second arterial conduit in coronary artery bypass surgery. However, concerns exist about the thermal injury incurred to the radial artery during endoscopic harvest. We sought to assess this effect both histologically and radiologically. Methods: From February 2015 to March 2016, 50 consecutive patients undergoing coronary artery bypass surgery utilizing endoscopically harvested radial artery were prospectively studied. Computerized tomography coronary angiography scan was performed randomly in 8 patients who also had their respective radial artery analyzed histologically at the time of harvest. Standard coronary angiography was also performed in 4 additional patients driven by symptoms recurrence. Results: All patients were available for follow up at 1 year following the surgery. There was no mortality during follow-up. Three patients (6%) developed transient complications in the harvest arm which resolved. All radial arteries were patent on follow-up imaging. Histological examination showed integrity of the arterial wall, intact endothelial lining, patent lumens and no significant pathological abnormalities. Conclusion: The use of endoscopic radial artery harvest was associated with few self-limiting morbidities and excellent patency rates. In addition, there was no evidence of any thermal or traumatic injuries sustained to the radial arteries when examined histologically. The use of endoscopically harvested radial arteries appears safe with excellent results.