David Taggart of the University of Oxford, United Kingdom, reviews the evidence for using the radial artery as the first choice for the second conduit in coronary bypass surgery. Dr. Taggart compares the use of the internal mammary artery, saphenous vein graft, and radial artery as second conduit options. Based on the available data, Dr. Taggart concludes that the radial artery is a good alternative when there are contraindications to using the RIMA.
This presentation was originally given during the SCTS Ionescu University program at the 2015 Annual Meeting of the Society for Cardiothoracic Surgery in Great Britain and Ireland. This content is published with the permission of SCTS. Please click here for more information on SCTS educational programs.
2 Comments
I have been using radial artery as a free conduit since 1994 and as a composite graft along with the left internal mammary since 1999.
It is an excellent conduit my choice over right mammary artery since majority of my patients are diabetics.
Thanks for this nice presentation.
The better results of in-situ BITA compared to RA can in part be due to a natural selection of targets in favour of BIMA.
Another issue is whether to use skeletonized or pedicled RA. Is there any evidence in favour of Sk- RA?
I think that the preventive effects of IMA skeletonizing is enhanced by preservation of internal thoracic veins, specially the medial one; therefore I do not recommend to section the latter in its superior course for the purpose of easing Proximal ITA harveating.
Finally, these results are based on classical SVG harvesting, we should redesign trials based on un-touched pedicled harvested SVG.
Your presentation is enough incentive to recall on a quality improveming CABG approach needing more team- based efforts rather than expéditive and quantitative-based surgical lines. Cordially