Forearm and Hand Function after Radial Artery Harvest for Coronary Artery Bypass Grafting: Subjective Patients’ Assessment
AbstractBackground: As arterial myocardial revascularization is proved to provide great results, radial artery use as a graft and its consequences remain an important issue.
Objectives: The aim of the study was to evaluate how patients assess their forearm and hand function after radial artery harvest for coronary artery bypass grafting (CABG).
Methods: 50 patients (mean age 52.2 ± 7.4 years) who underwent CABG at least 6 months (median follow up
11.75 months) earlier filled in a questionnaire concerning hand and forearm efficiency and discomfort.
Results: The global efficiency of the operated upper extremity was scored mean 8.87 ± 1.26 points on a 10-point scale and it was worse in patients who noticed at least one sort of disorder than in patients with no problems (8.6 ± 1.4 versus 9.4 ± 0.7 points; P = .04). Paresthesias were the most often reported disorders; 21 patients felt some tingling and/or numbness, but in only 14 (28%) could the symptoms be considered as related to the operation. 20 patients (40%) declared that they felt some scar-related discomfort. Reduced grip strength and excessive hand fatigue were reported by 20% and 10% of patients, respectively. None of those interviewed answered that symptoms reported affected his or her life activity on any level.
Conclusion: The hand and forearm efficiency after radial artery harvest for CABG was highly evaluated by the majority of patients. Despite the fact that many patients reported some surgery-related problems, they did not notice extremity dysfunction that could limit their life activity.
Acar C, Jebara VA, Portoghese M, et al. 1992. Revival of the radial artery for coronary artery bypass grafting. Ann Thorac Surg 54:652-9.
Allen RH, Szabo RM, Chen JL. 2004. Outcome assessment of hand function after radial artery harvesting for coronary artery bypass. J Hand Surg Am 29:628-37.
Budillon AM, Nicolini F, Agostinelli A, et al. 2003. Complications after radial artery harvesting for coronary artery bypass grafting: Our experience. Surgery 133:283-7.
Chim H, Bakri K, Moran SL. 2015. Complications related to radial artery occlusion, radial artery harvest, and arterial lines. Hand Clin 31:93-100.
Denton TA, Trento L, Cohen M, et al. 2001. Radial artery harvesting for coronary bypass operations: neurologic complications and their potential mechanism. J Thorac Cardiovasc Surg 121:951-6.
Fox AD, Whiteley MS, Phillips-Hughes J, et al. 1999. Acute upper limb ischemia: a complication of coronary artery bypass grafting. Ann Thorac Surg 67:535-7.
Hata M, Raman J, Seevanayagam S, et al. 2002. Post radial artery harvest hand perception. Postoperative 12-month follow-up results. Circ J 66:816-18.
Ikizler M, Ozkan S, Dernek S, et al. 2005. Does radial artery harvesting for coronary revascularization cause neurological injury in the forearm and hand? Eur J Cardiothorac Surg 28:420-4.
Kowalczyk P, Knap O, Kempinska A, et al. 2009. Ocena odległego wpływu pobrania tetnicy promieniowej do pomostowania tetnic wiencowych na sprawnosc i ukrwienie konczyny górnej. Kardiochir Torakochir Pol 6:17-22.
Lee HS, Heo YJ, Chang BC. 2005. Long-term digital blood flow after radial artery harvesting for coronary artery bypass grafting. Eur J Cardiothorac Surg 27:99-103.
Manabe S, Tabuchi N, Toyama M, et al. 2004. Oxygen pressure measurement during grip exercise reveals exercise intolerance after radial artery harvest. Ann Thorac Surg 77:2066-70.
Reddy VS, Parikh SM, Drinkwater DC Jr, et al. 2002. Morbidity after procurement of radial arteries in diabetic patients and the elderly undergoing coronary revascularization. Ann Thorc Surg 73:803-8.
Royse AG, Royse CF, Shah P, et al. 1999. Radial artery harvest technique, use and functional outcome. Eur J Cardiothorac Surg 15:186-93.
Saeed I, Anyanwu AC, Yacoub MH, et al. 2000. Subjective patients outcomes following coronary artery bypass using the radial artery: results of a cross-sectional survey of harvest site complications and quality of life. Eur J Cardiothorac Surg 20:1142-6.
Schmid C, Tjan TD, Scheld HH. 2002. Severe complex regional pain syndrome typeII after radial artery harvesting. Ann Thorac Surg 74:1250-1.
Serrichio M, Gaudino M, Tondi P, et al. 1999. Haemodynamic and functional consequences of radial artery removal for coronary artery bypass grafting. Am J Cardiolog 84:1353-6.
Shapira OM, Eskenazi BR, Hunter CT, et al. 2006. Endoscopic versus conventional radial artery harvest-is smaller better? J Card Surg 21:329-35.
Siminelakis S, Karfis E, Anagnostopoulos C, et al. 2004. Harvesting radial artery and neurologic complications. J Card Surg 19:505-10.
Taggart DP. 1999. The radial artery as a conduit for coronary artery bypass grafting. Heart 82:409-10.
Tatoulis J, Buxton BF, Fuller JA. 1998. Bilateral radial artery grafts in coronary reconstruction: technique and early results in 261 patients. Ann Thorac Surg 66:714-20.
Zembala M(red.): 2002. Chirurgia naczyn wiencowych. PZWL, Warszawa.
How to Cite
Author Disclosure & Copyright Transfer Agreement
In order to publish the original work of another person(s), The Heart Surgery Forum® must receive an acknowledgment of the Author Agreement and Copyright Transfer Statement transferring to Forum Multimedia Publishing, L.L.C., a subsidiary of Carden Jennings Publishing Co., Ltd. the exclusive rights to print and distribute the author(s) work in all media forms. Failure to check Copyright Transfer agreement box below will delay publication of the manuscript.
A current form follows:
The author(s) hereby transfer(s), assign(s), or otherwise convey(s) all copyright ownership of the manuscript submitted to Forum Multimedia Publishing, LLC (Publisher). The copyright transfer covers the exclusive rights to reproduce and distribute the article and the material contained therein throughout the world in all languages and in all media of expression now known or later developed, including but not limited to reprints, photographic reproduction, microfilm, electronic data processing (including programming, storage, and transmission to other electronic data record(s), or any other reproductions of similar nature), and translations.
However, Publisher grants back to the author(s) the following:
- The right to make and distribute copies of all or part of this work for use of the author(s) in teaching;
- The right to use, after publication in The Heart Surgery Forum, all or part of the material from this work in a book by the author(s), or in a collection of work by the author(s);
- The royalty-free right to make copies of this work for internal distribution within the institution/company that employs the author(s) subject to the provisions below for a work-made-for-hire;
- The right to use figures and tables from this work, and up to 250 words of text, for any purpose;
- The right to make oral presentations of material from this work.
Publisher reserves the right to grant or refuse permission to third parties to republish all or part of the article or translations thereof. To republish, such third parties must obtain written permission from the Publisher. (This is in accordance with the Copyright Statute, United States Code, Title 17. Exception: If all authors were bona fide officers or employees of the U.S. Government at the time the paper was prepared, the work is a “work of the US Government” (prepared by an officer or employee of the US Government as part of official duties), and therefore is not subject to US copyright; such exception should be indicated on signature lines. If this work was prepared under US Government contract or grant, the US Government may reproduce, royalty-free, all or portions of this work and may authorize others to do so, for official US Government purposes only, if the US Government contract or grant so requires.
I have participated in the conception and design of this work and in the writing of the manuscript and take public responsibility for it. Neither this manuscript nor one with substantially similar content under my authorship has been published, has been submitted for publication elsewhere, or will be submitted for publication elsewhere while under consideration by The Heart Surgery Forum, except as described in an attachment. I have reviewed this manuscript (original version) and approve its submission. If I am listed above as corresponding author, I will provide all authors with information regarding this manuscript and will obtain their approval before submitting any revision. I attest to the validity, accuracy, and legitimacy of the content of the manuscript and understand that Publisher assumes no responsibility for the validity, accuracy, and legitimacy of its content. I warrant that this manuscript is original with me and that I have full power to make this Agreement. I warrant that it contains no matter that is libelous or otherwise unlawful or that invades individual privacy or infringes any copyright or other proprietary right. I agree to indemnify and hold Publisher harmless of and from any claim made against Publisher that relates to or arises out of the publication of the manuscript and agree that this indemnification shall include payment of all costs and expenses relating to the defense of any such claim, including all reasonable attorney’s fees.
I warrant that I have no financial interest in the drugs, devices, or procedures described in the manuscript (except as disclosed in the attached statement).
I state that the institutional Human Subjects Committee and/or the Ethics Committee approved the clinical protocol reported in this manuscript for the use of experimental techniques, drugs, or devices in human subjects and appropriate informed consent documents were utilized.
Furthermore, I state that any and all animals used for experimental purposes received humane care in USDA registered facilities in compliance with the “Principles of Laboratory Animal Care” formulated by the National Society for Medical Research and the “Guide for the Care and Use of Laboratory Animals” prepared by the Institute of Laboratory Animal Resources and published by the National Institutes of Health (NIH Publication No. 85-23, revised 1985).