TY - JOUR
T1 - Less invasive radial artery harvesting: Two years' experience
AU - Buklas, Dimitrios
AU - Gelpi, Guido
AU - Neri, Eugenio
AU - Babatasi, Gerard
AU - Lepage, Olivier
AU - Ivascau, Calin
AU - Bichi, Samuele
AU - Antona, Carlo
AU - Gerard, Jean Louis
AU - Khayat, André
AU - Massetti, Massimo
PY - 2005
Y1 - 2005
N2 - Background. For coronary surgery we often use the radial artery (RA) instead of the saphenous vein, trying to exploit the advantages offered by this conduit. To eliminate the problems regarding alteration of upper-extremity function after RA procurement related to the standard conventional harvesting technique, we started using the less invasive harvesting technique with surprisingly good preliminary results. To compare the outcomes of open versus less invasive harvesting procedures, a prospective, nonrandomized study was developed by 2 centers. Methods. From January 2001 to March 2003, there were 87 consecutive patients in the less invasive radial artery harvesting (LIRAH) group and 90 patients in the conventional radial artery harvesting (CRAH) group. Patient characteristics and demographics were similar in the groups. Data collection was made to evaluate possible benefits of the LIRAH technique in terms of fewer forearm and hand complications, better aesthetics, and improved patient satisfaction. Results. Between January 11, 2001, and March 30, 2003, 177 patients underwent either primary or redo coronary artery revascularizations with, procurement of the RA for use as a conduit with the less invasive harvesting technique. The mean follow-up was 2 months. Four patients died, and overall mortality was 2.26%. One hundred seventy-three patients were successfully examined during the first postoperative control, 85 in the LIRAH group and 88 patients in the CRAH group. Objective and subjective data were collected from the consultant. The overall average age was 60.5 years (range, 40-77 years). In the LIRAH group, the mean overall incision length (when 2 incisions were necessary, both, incision lengths were measured) was 5.6 cm (range, 4-10 cm), and the mean vessel length was 16 cm (range, 10-19 cm). Eighteen patients (20.6%) necessitated double incision. Mean harvesting time (from incision to skin closure) was 43.3 min (range, 25-70 min). Fourteen patients (16.4%) presented some kind of complication during the study. There were no cases with, acute ischemia, bleeding, or re-exploration. Seventy-five patients (88.2%) found the cosmetic result excellent. Ten patients (11.8%) found it good, and none considered it mediocre. In the CRAH group, the mean incision length was 20 cm (range, 18-22 cm), and the mean vessel length was 18 cm (range, 17-20 cm ). Mean harvesting time (from incision to skin closure) was 30.8 min (range, 14-45 min). Thirty-four patients (38.6%) presented some kind of complication during the study. Three patients (3.5%) found the cosmetic result excellent. Forty-three (48.8%) found it good, and 42 (47.7%) considered it mediocre. Conclusions. A potential of fewer neurological forearm postoperative complications, better aesthetics, and improved patient satisfaction can be achieved by the LIRAH technique. © 2005 Forum Multimedia Publishing, LLC.
AB - Background. For coronary surgery we often use the radial artery (RA) instead of the saphenous vein, trying to exploit the advantages offered by this conduit. To eliminate the problems regarding alteration of upper-extremity function after RA procurement related to the standard conventional harvesting technique, we started using the less invasive harvesting technique with surprisingly good preliminary results. To compare the outcomes of open versus less invasive harvesting procedures, a prospective, nonrandomized study was developed by 2 centers. Methods. From January 2001 to March 2003, there were 87 consecutive patients in the less invasive radial artery harvesting (LIRAH) group and 90 patients in the conventional radial artery harvesting (CRAH) group. Patient characteristics and demographics were similar in the groups. Data collection was made to evaluate possible benefits of the LIRAH technique in terms of fewer forearm and hand complications, better aesthetics, and improved patient satisfaction. Results. Between January 11, 2001, and March 30, 2003, 177 patients underwent either primary or redo coronary artery revascularizations with, procurement of the RA for use as a conduit with the less invasive harvesting technique. The mean follow-up was 2 months. Four patients died, and overall mortality was 2.26%. One hundred seventy-three patients were successfully examined during the first postoperative control, 85 in the LIRAH group and 88 patients in the CRAH group. Objective and subjective data were collected from the consultant. The overall average age was 60.5 years (range, 40-77 years). In the LIRAH group, the mean overall incision length (when 2 incisions were necessary, both, incision lengths were measured) was 5.6 cm (range, 4-10 cm), and the mean vessel length was 16 cm (range, 10-19 cm). Eighteen patients (20.6%) necessitated double incision. Mean harvesting time (from incision to skin closure) was 43.3 min (range, 25-70 min). Fourteen patients (16.4%) presented some kind of complication during the study. There were no cases with, acute ischemia, bleeding, or re-exploration. Seventy-five patients (88.2%) found the cosmetic result excellent. Ten patients (11.8%) found it good, and none considered it mediocre. In the CRAH group, the mean incision length was 20 cm (range, 18-22 cm), and the mean vessel length was 18 cm (range, 17-20 cm ). Mean harvesting time (from incision to skin closure) was 30.8 min (range, 14-45 min). Thirty-four patients (38.6%) presented some kind of complication during the study. Three patients (3.5%) found the cosmetic result excellent. Forty-three (48.8%) found it good, and 42 (47.7%) considered it mediocre. Conclusions. A potential of fewer neurological forearm postoperative complications, better aesthetics, and improved patient satisfaction can be achieved by the LIRAH technique. © 2005 Forum Multimedia Publishing, LLC.
KW - Adult
KW - Aged
KW - Cardiology and Cardiovascular Medicine
KW - Coronary Artery Bypass
KW - Female
KW - France
KW - Humans
KW - Italy
KW - Male
KW - Middle Aged
KW - Minimally Invasive Surgical Procedures
KW - Radial Artery
KW - Tissue and Organ Harvesting
KW - Adult
KW - Aged
KW - Cardiology and Cardiovascular Medicine
KW - Coronary Artery Bypass
KW - Female
KW - France
KW - Humans
KW - Italy
KW - Male
KW - Middle Aged
KW - Minimally Invasive Surgical Procedures
KW - Radial Artery
KW - Tissue and Organ Harvesting
UR - http://hdl.handle.net/10807/103943
U2 - 10.1532/HSF98.20051147
DO - 10.1532/HSF98.20051147
M3 - Article
SN - 1098-3511
VL - 8
SP - 363
EP - 368
JO - THE HEART SURGERY FORUM
JF - THE HEART SURGERY FORUM
ER -