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Prospective randomized trial of endoscopic vs open radial artery harvest for CABG: clinical outcome, patient satisfaction and mid-term RA graft patency.
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  • Muhammed Tamim,
  • CHRISTOS ALEXIOU,
  • Donya Al-Hassan,
  • Khaled Al-Faraidy
Muhammed Tamim
King Fahd Military Medical Complex
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CHRISTOS ALEXIOU
King Fahd Military Medical Complex
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Donya Al-Hassan
King Fahd Military Medical Complex
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Khaled Al-Faraidy
King Fahd Military Medical Complex
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Abstract

Background and Aim Endoscopic radial artery (RA) harvest (ERAH) is an alternative to open RA harvest (ORAH) technique. Our aim was to compare clinical outcome, patent satisfaction and 1-year angiographic patency rates after ERAH and ORAH. Patients and methods 50 patients undergoing multivessel CABG were prospectively randomized to two groups. In the ERAH group (25 patients) the RA was harvested endoscopically and in the ORAH group (25 patients) openly. Results There were not differences between the groups in preoperative characteristics. Length of skin incision was shorter in ERAH (p<0.001) but there were not differences in the length of RA, harvest time, blood flow and pulsatility index after ERAH and ORAH. Wound healing was uniformly smooth in ERAH and there were 2 haematomas and 1 infection in ORAH. Postoperatively, major neuralgias were present in 5 patients in ORAH and none in ERAH (p=0.05) and minor neuralgias in 11 and 3 patients (p=0.02) respectively. Twenty-four patients in ERAH and 4 in ORAH graded their experience as excellent (p<00001). One-year angiographic RA patency was 90% without intergroup difference. Target vessel stenosis < 90% adversely affected RA patency (p<0.0001). Conclusions In expert center, ERAH has no negative impact on time harvest, length and quality of RA conduit. Moreover, ERAH may provide better wound healing, and is associated with less neuralgias, excellent cosmetic result and better patient satisfaction. RA graft patency is unaffected by the harvesting technique and is excellent when placed to a target coronary artery vessel with stenosis > 90%.

Peer review status:ACCEPTED

16 Apr 2020Submitted to Journal of Cardiac Surgery
18 Apr 2020Submission Checks Completed
18 Apr 2020Assigned to Editor
18 Apr 2020Reviewer(s) Assigned
21 Apr 2020Review(s) Completed, Editorial Evaluation Pending
22 Apr 2020Editorial Decision: Revise Minor
30 Apr 20201st Revision Received
01 May 2020Assigned to Editor
01 May 2020Submission Checks Completed
01 May 2020Reviewer(s) Assigned
04 May 2020Review(s) Completed, Editorial Evaluation Pending
05 May 2020Editorial Decision: Revise Minor
06 May 20202nd Revision Received
08 May 2020Assigned to Editor
08 May 2020Submission Checks Completed
08 May 2020Review(s) Completed, Editorial Evaluation Pending
08 May 2020Editorial Decision: Accept