Harvesting the Radial Artery: Does It Affect Early Postoperative Hand Function?
Background: The radial artery (RA) is increasingly being used as a conduit for coronary artery bypass grafting. Previous studies have demonstrated that there is no significant deterioration in hand function in the long term. The aim of this study was to assess whether removal of the RA caused any alteration in the function or power of the hand 5 days postoperatively that would affect the patient's ability for self care on returning home.
Methods: A consecutive series of 37 patients undergoing RA harvesting was assessed over a period of 12 months from August 2000 to July 2001 as part of a prospective controlled trial. Grip power and fine motor skills in the operated hand were assessed preoperatively with an elasticated grip strength tester and an 18-hole peg board. This test was repeated 5 days postoperatively. The results were analyzed with a paired-sample t test to assess whether there was a significant difference between preoperative and postoperative hand function.
Results: The analysis showed that there was no statistically significant difference in fine motor function or grip power following surgery to harvest the RA.
Conclusion: This study provides evidence to suggest that the RA can be safely harvested for use as a conduit in coronary artery bypass grafting, with no significant short-term deterioration in hand function.
Pola P, Serricchio M, Flore R, Manasse E, Favuzzi A, Possati GF. 1996. Safe removal of the radial artery for myocardial revascularization: a Doppler study to prevent ischemic complications to the hand. J Thorac Cardiovasc Surg 112:737-44.nPossati G, Gaudino M, Alessandrini F, et al. 1998. Midterm clinical and angiographic results of radial artery grafts used for myocardial revascularization. J Thorac Cardiovasc Surg 116:1015-21.nRoyse AG, Royse CF, Shah P, Williams A, Kaushik S, Tatoulis J. 1999. Radial artery harvest technique, use and functional outcome. Eur J Cardiothorac Surg 15:186-93.nRoyse AG, Royse CF, Tatoulis J. 1999. Total arterial coronary revascularization and factors influencing in-hospital mortality. Eur J Cardiothorac Surg 16:499-505.nRuengsakulrach P, Eizenberg N, Fahrer C, Fahrer M, Buxton BF. 2001.nSurgical implications of variations in hand collateral circulation: anatomy revisited. J Thorac Cardiovasc Surg 122:682-6.nSadaba JR, Conroy JL, Burniston M, Maughan J, Munsch C. 2001. Effect of radial artery harvesting on tissue perfusion and function of the hand. Cardiovasc Surg 9:378-82.nBrodman RF, Frame R, Camacho M, Hu E, Chen A, Hollinger I. 1996. Routine use of unilateral and bilateral radial arteries for coronary artery bypass graft surgery. J Am Coll Cardiol 28:959-63.nChen AH, Nakao T, Brodman RF, et al. 1996. Early postoperative angiographic assessment of radial grafts used for coronary artery bypass grafting. J Thorac Cardiovasc Surg 111:1208-12.nDumanian GA, Segalman K, Mispireta LA, Walsh JA, Hendrickson MF, Wilgis EF. 1998. Radial artery use in bypass grafting does not change digital blood flow or hand function. Ann Thorac Surg 65:1284-7.nHayes EC, L Ecuyer KM. 1998. A standard of care for radial artery grafting. Am J Crit Care 7:429-35.nJarvis MA, Jarvis C, Jones P, Spyt T. 2000. Reliability of Allen's test in selection of patients for radial artery harvest. Ann Thorac Surg 70:1362-5.nNunoo-Mensah J. 1998. An unexpected complication after harvesting of the radial artery for coronary artery bypass grafting. Ann Thorac Surg 66:929-31.nSaeed I, Anyanwu A, Yacoub M, Amrani M. 2001. Subjective patient outcomes following coronary 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.nSilva J, Malillos S, Villasenor M, et al. 2000. Midterm results of coronary bypass surgery exclusively with arterial revascularization. Rev Esp Cardiol 53:1201-8.nWolff CA, Scott C, Banks TA. 1997. The radial artery: an exciting alternative conduit in coronary artery bypass surgery. Crit Care Nurse 17:34-9.n
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).