Total endoscopic, video-assisted radial artery harvest: Report of the first 55 cases

Objectives: Wound related morbidity after open-incision harvesting of vessel conduits for CABG due to a prolonged postoperative recovery. The endoscopic approach was used to decrease neurological complications, to improve aesthetics and patient satisfaction and demand. Material and Methods: In 55 patients underwent CABG we performed an endoscopic radial artery (ra) harvesting in the non-dominant hand. The mean age of the patients was 63,8±9,2 years. A non invasive Doppler-method and Allen-test were used to test the collateral ulnar circulation. A small 1cm incision just proximal to the radial styloid prominence was used for insertion of the vasoview 5 system from Guidant. After CO 2 insufflations the (ra) could be mobilized by cannula, ligated and divided proximally. The inserted bipolar scissor is used to cauterise and divide the artery side branches. Results: After successfully endoscopically removing (ra) grafts can be used for CABG in all patients. The conduit length ranged from 18,5–25cm. The total harvesting time including skin closure has been 23,5±4,8 minutes. No significant in-hospital complications were obtained. No myocardial infarction or need of re-intervention were observed. Conclusions: In our initial experience, endoscopic radial artery harvesting can be performed safely, with minor complications. The aesthetics and patient satisfaction and demand can be obtained at a full-length radial artery harvest.