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Tissue perfusion in non-donor and donor forearm/hand after radial artery harvest: 1- and 5-year follow-up

^a Department of Cardiothoracic Surgery, The Yorkshire Heart Centre, D-Floor, Jubilee Wing, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK
^b Department of Medical Physics, The Yorkshire Heart Centre, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK

*Corresponding author. Tel.: +44-113-3923368; fax: +44-113-3928092.

E-mail address: samir.shah{at}leedsth.nhs.uk (S.S. Shah).

Radio-labeled red cell perfusion scan of the non-donor/donor forearm/hand was undertaken, 1- and 5-years post operation, in 12 patients who had received a radial artery graft during myocardial revascularisation. Results were analysed using a Wilcoxon Signed Rank test (P-value <0.05 was taken as statistically significant). Mean tissue perfusion (in milliliters/100 ml tissue/min) declined in the non-donor (–10.06%, P=0.07) and donor (–6.65%, P=0.15) forearm, respectively, compared to 1 year post radial artery harvest. The statistically significant observed difference in tissue perfusion between the non-donor (21.9±5.1) and donor (17.5±3.7) forearm (P=0.0007) at 1 year was maintained at 5 years, non-donor and donor, 19.5±3.7 and 16.2±3.4 (P=0.001), respectively. The same pattern in tissue perfusion was observed in the non-donor/donor hand. This study demonstrates that, over time, there is little recovery in perfusion in the donor forearm/hand from ulnar artery collateral circulation. There is a significant and persistent difference in tissue perfusion between the non-donor/donor forearm/hand at 5 years post radial artery harvest. Although no functional deficit or overt ischaemic events were recorded, these findings may influence the choice of conduit and the information given when obtaining consent in patients undergoing myocardial revascularisation.

Key Words: Radial artery; Limb perfusion; Coronary artery bypass