Aftab Yunus, Hassan-ul Banna, Tahir Naveed, Jeetendra Mishra, Lok M Sinha.
Early Results of Radial Artery as a Second Conduit in Coronary Artery Bypass Grafting in a Developing Country.
Pak J Med Health Sci Jan ;7(3):837-9.

Aim: To determine early-outcome effects of Radial Artery (RA) use as a second arterial graft after left internal mammary artery (LITA) in patients undergoing coronary artery bypass grafting (CABG). Methods: From March 2011 to September 2013, total of 167 consecutive patients fulfilling the inclusion and exclusion criteria, who underwent CABG at Mayo Hospital/KEMU, Lahore and had left RA used as a conduit were included in this study. All patients had modified Allen’s test to access the collateral circulation of hand (Ulnar Artery). Patients having inadequate collateral ulnar circulation as determined by the modified Allen’s test, patients with concomitant valvular disease requiring replacement, patients who became unstable on induction of anaesthesia and those with impaired renal function were excluded from the study. RA was used as a second arterial conduit after LITA to Left Anterior Descending artery. It was used on native coronary artery having more than 70 percent stenosis. Prospective surveillance of postoperative complications like arrhythmias, changes in ECG, use of inotropes, ICU stay, radial artery harvest site local complication, mortality were studied and CT angiogram was done to access the patency of radial artery in the first year. Results: During the study, out of 167 patients, 108 (64%) were male and 59(36%) were female. The early postoperative complications included 1.19%mortality, perioperative MI of 1.1% and reoperation for bleeding was 1.7%. Local complications following RA harvesting included paresthesia of hand at 2.9% and Scar formation in 2.3%. CT angiography was performed after one year follow up in 86 patients, which showed patent RA graft in 84 (97.7%) patients. Two patients (2.3%) had RA stenosis. Conclusions: The results indicate that RA can be used routinely in surgical revascularization of heart with good early results.

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