M A Greene1, M A Malias. 1. Division of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, USA. mgreene@health-first.org
Abstract
BACKGROUND: Radial arteries are being used frequently for coronary artery bypass conduits, and surgeons are appropriately concerned about the risks of ischemia, infection, and neurologic dysfunction of the "donor" arm. We present our record of donor site complications, with emphasis on the safety of radial usage in patients older than 65 years of age. METHODS: A total of 343 radial arteries were removed from 217 patients, aged 37 to 83 years. Forty-nine (23%) of the patients were women; 126 of the radial arteries were from patients aged 65 years or older. Four patients died. In the remaining 213 patients, 338 donor arms were examined for at least 6 weeks postoperatively for evidence of infection, ischemia, hematoma, seroma, or paresthesia. RESULTS: No donor arms developed symptoms of 'ischemia or motor dysfunction. Two of 338 (0.6%) arms developed hematomas requiring operative drainage. Relatively minor complications of stitch abscesses, skin dehiscence, superficial infection, and small hematomas or seromas affected another 14 arms (4.1%). Cutaneous paresthesias in the radial distribution of the lateral antebrachial cutaneous nerve or superficial branch of the radial nerve were noted postoperatively in 36 arms (10.7%). The risk of any arm complication occurring was 13% in the 65 and older group and 17% in those less than 65 years old (p = NS). CONCLUSIONS: The risk of a major arm complication from radial artery harvesting for coronary bypass is low, even in patients of advanced age.
BACKGROUND: Radial arteries are being used frequently for coronary artery bypass conduits, and surgeons are appropriately concerned about the risks of ischemia, infection, and neurologic dysfunction of the "donor" arm. We present our record of donor site complications, with emphasis on the safety of radial usage in patients older than 65 years of age. METHODS: A total of 343 radial arteries were removed from 217 patients, aged 37 to 83 years. Forty-nine (23%) of the patients were women; 126 of the radial arteries were from patients aged 65 years or older. Four patients died. In the remaining 213 patients, 338 donor arms were examined for at least 6 weeks postoperatively for evidence of infection, ischemia, hematoma, seroma, or paresthesia. RESULTS: No donor arms developed symptoms of 'ischemia or motor dysfunction. Two of 338 (0.6%) arms developed hematomas requiring operative drainage. Relatively minor complications of stitch abscesses, skin dehiscence, superficial infection, and small hematomas or seromas affected another 14 arms (4.1%). Cutaneous paresthesias in the radial distribution of the lateral antebrachial cutaneous nerve or superficial branch of the radial nerve were noted postoperatively in 36 arms (10.7%). The risk of any arm complication occurring was 13% in the 65 and older group and 17% in those less than 65 years old (p = NS). CONCLUSIONS: The risk of a major arm complication from radial artery harvesting for coronary bypass is low, even in patients of advanced age.
Authors: Christian L Carranza; Martin Ballegaard; Mads U Werner; Philip Hasbak; Andreas Kjær; Klaus F Kofoed; Jane Lindschou; Janus Christian Jakobsen; Christian Gluud; Peter Skov Olsen; Daniel A Steinbrüchel Journal: Trials Date: 2014-04-23 Impact factor: 2.279