Forearm and Hand Function after Radial Artery Harvest for Coronary Artery Bypass Grafting: Subjective Patients’ Assessment
DOI:
https://doi.org/10.1532/hsf.1485Abstract
Background: 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.
References
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.
