Document Detail


Radial artery harvesting for coronary artery bypass grafting: a stepwise-made decision.
MedLine Citation:
PMID:  18721569     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to propose a safe, stepwise, testing system to select radial arteries that are suitable for conduits on the basis of their morphologies and characteristics of the collateral circulation. METHODS: Before operation, 113 patients underwent the modified Allen test, Doppler ultrasonography, and pulse oximetry testing. Morphologic criteria used for radial artery exclusion were small size of radial or ulnar artery (< 2 mm in inner diameter), diffuse calcifications, and congenital anomalies of forearm arteries. Collateral circulation was interpreted as insufficient if the reverse flow in the anatomic snuffbox was absent or if the increase of the ulnar peak systolic flow velocity was less than 20%. RESULTS: A positive modified Allen test was found in 10.6% of patients. As assessed by Doppler ultrasonography, 27 patients (23.9%) were not candidates for radial artery harvesting according to morphologic and functional abnormalities of forearm and hand circulation. Pulse oximetry test results were abnormal in 6.2%. After a follow-up period of 8.9 +/- 1.8 months, 23 patients (29.1% of operated patients) were controlled for Doppler ultrasonographic changes in the ulnar artery. The mean peak systolic flow velocity was significantly higher than the preoperative value measured at rest (p < 0 .001). CONCLUSIONS: After preoperative tests, including the modified Allen test, Doppler ultrasonography, and pulse oximetry, 30.1% of patients were not considered candidates for radial artery harvesting. This method provides preoperative radial artery selection according to its morphologies, compensatory capacity of collateral circulation, and anatomic properties of ulnar artery.
Authors:
Petar M Vuković; Sandra S Radak; Miodrag S Perić; Dusko G Nezić; Aleksandar M Knezević
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  86     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-25     Completed Date:  2008-09-19     Revised Date:  2008-09-22    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  828-31     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia. petarvuk@eunet.yu
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Bypass*
Decision Making*
Female
Humans
Male
Middle Aged
Oximetry
Radial Artery / anatomy & histology,  transplantation*
Tissue and Organ Harvesting / methods*
Ulnar Artery / anatomy & histology
Ultrasonography, Doppler

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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