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Routine Use of the Radial Artery for Coronary Artery Revascularization

Department of Cardiovascular Surgery Escorts Heart Institute and Research Centre New Delhi, India
Zile Singh Meharwal, MCh Tel: 91 11 682 5000 Fax: 91 11 682 5013 email: meharwal{at}hotmail.com Department of Cardiovascular Surgery, Escorts Heart Institute and Research Centre, Okhla Road, New Delhi 110025, India.

Between January 1997 and December 2000, a total of 4,000 patients underwent myocardial revascularization using the radial artery as one of the conduits. The mean age of the patients was 54 ± 7 years, and 92.8% of them were male. Of these patients, 31% had a left ventricular ejection fraction below 40% and 22.8% underwent urgent operation. A total of 4,225 distal anastomoses were performed using the radial artery. The average number of grafts was 3.3 ± 0.5. The hospital mortality rate was 0.8%. Low cardiac output, inotropic support, perioperative myocardial infarction, reoperation for bleeding, atrial fibrillation, and sternal infection occurred in 1.8%, 2.8%, 1.2%, 1.2%, 16.8%, and 1.2% of the patients, respectively. None of the patients had major ischemia of the hand. The incidence of local hand wound complications was 0.7% (wound infection, 0.4%; wound dehiscence without infection, 0.1%; and hematoma, 0.2%). The average length of stay in the intensive care unit was 20 ± 7 hours and in the hospital was 6 ± 2 days. Postoperative angiography, performed in 106 patients at a mean interval of 18 months, showed that 92.4% of radial artery, 96.2% of internal mammary artery, and 76.2% of saphenous vein grafts were patent.