Endoscopic Radial Artery Harvesting
A bypass operation includes two surgical procedures:
The bypass surgery involves the use of a healthy blood vessel to “bypass” a damaged or blocked artery in the heart.
The second procedure is the removal of a healthy blood vessel, in this case the radial artery in the patient’s forearm. This vessel will be used to construct the bypass.
Recent advances in technology have made it possible to perform this second procedure in a new way, through endoscopic small incision surgery. This new procedure results in less muscle and tissue damage when removing the vessel graft. This may eliminate many of the complications associated with the former technique, which required a long incision the length of the graft.
In the past a vessel was often removed from the patient’s leg, called a saphenous vein graft. Now surgeons may choose to remove the radial artery in the patient’s forearm instead.
To harvest the radial artery the surgeon makes two small one-inch incisions in the patient’s forearm. One incision is made near the wrist; the other is made near the elbow.
Because radial arteries from the arm are accustomed to higher blood pressure than leg veins, they may prove to be more durable bypass grafts. In the past surgeons had to harvest the radial artery through a long incision from the elbow to the wrist, increasing the potential for complications.
How Is Endoscopic Radial Artery Harvesting Performed?
An endoscope, a special instrument used to view the artery, is connected to a video camera and inserted through the small incisions in the forearm. The endoscope allows the surgeon to remove the artery with minimal stress to the forearm.
Patient Benefits From Radial Artery Harvesting
The potential benefits from this procedure include the following:
- The patient should experience less tissue scarring.
- The site of the patient’s incision should be less painful.
- The recovery from surgery should be shorter, allowing the patient to concentrate on cardiac rehabilitation.
In most cases the radial artery can be harvested successfully. However, every patient is unique, and the surgical team will recommend the best procedure for each patient.
It is important to remember that the goal of any bypass surgery is to increase blood flow to the heart’s arteries. Increased blood flow may:
- Provide relief from angina (pain or tightness in the chest)
- Improve the pumping ability of the heart muscle
- Reduce the risk of heart attacks
- Most importantly, improve the quality of life