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Ann Thorac Surg 2004;78:539-542
© 2004 The Society of Thoracic Surgeons

Original article: cardiovascular

Harvest of the radial artery for coronary artery surgery preserves maximal blood flow of the forearm

Alistair G. Royse, MBBS, MDa,c*, Colin F. Royse, MBBS, MDb,c, Atul Maleskar, MBChBa, Anurag Garg, MBChBa

a Department of Cardiac Surgery, The Royal Melbourne Hospital, Melbourne, Australia
b department of Anaesthesia and Pain Management, University of Melbourne, Melbourne, Australia
c department of Pharmacology, University of Melbourne, Melbourne, Australia

Accepted for publication February 17, 2004.

* Address reprint requests to Dr Royse, PO Box 2135, The Royal Melbourne Hospital, Victoria, Australia, 3050
e-mail: alistair.royse{at}mh.org.au

BACKGROUND: Use of the radial artery as a conduit for coronary artery surgery has increased dramatically. It has been assumed that blood flow to the forearm will not be compromised by its removal.

METHODS: Sixteen patients who had the left radial artery harvested for coronary surgery at least 3 months earlier were studied. The right radial artery was not harvested. The radial, ulnar, and brachial artery diameters and flows were measured using pulsed wave Doppler with a 15-MHz linear array transducer. Measurements were performed at rest, with the right radial artery compressed, and after ischemia with forearm exercise.

RESULTS: At rest, the (mean ± SE) diameter of the left ulnar artery was consistently greater than the right (2.4 ± 0.09 versus 2.1 ± 0.09 mm, p = 0.001) as was flow (74 ± 9.9 versus 48 ± 8.5 mL/min, p = 0.005). There was no difference between diameters or flows in the brachial arteries. After compression of the radial artery, flow increased in the right ulnar artery from 39 ± 8.0 to 72 ± 17.6 mL/min (p = 0.019) without an increase in ulnar artery size and was not different from the left ulnar artery flow at rest (p = 0.440). After ischemic forearm exercise, flow increased in the two brachial arteries almost equally (left, 348 ± 50; right, 371 ± 63 mL/min).

CONCLUSIONS: Blood flow to the forearm and hand is not compromised by harvest of the radial artery.




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