Technical Aspects of Radial Artery Grafting for Coronary Surgery

Abstract

The radial artery (RA) has seen a recent resurgence in coronary artery bypass grafting (CABG) surgery. Recent randomized evidence has shown higher long-term patency rates and better clinical outcomes with the RA when compared to other conduits such as the right internal thoracic artery and saphenous vein grafts. In fact, the RA is now class I indication as the second conduit in CABG. Therefore, it is important that the coronary surgeon is familiar with the RA and its use in CABG. In this report we describe our operative technique for RA harvesting and use in CABG. As with any surgical procedure, patient selection is key. We describe our approach to screening including duplex ultrasonography and plethysmography, endoscopic and open harvesting techniques, preservation and grafting strategies, target vessel selection, and anastomotic techniques.