The coronary arteries supply oxygen-rich blood to the heart muscles and help to pump blood to the entire body. These arteries can narrow or become blocked due to the build-up of fatty substances on the walls, which can interfere with the normal functioning of the heart. This condition is called coronary artery disease (CAD) and can be treated by coronary artery bypass graft surgery (CABG). The affected coronary artery is treated by bypassing the narrowed part with a piece of artery taken from another part of your body. Radial artery surgery involves using the radial artery at the wrist as a graft.
You may not be a candidate for radial artery graft if you have carpal tunnel syndrome (pinched nerve in the wrist), painful fingers or Raynaud’s syndrome (numbness of fingers during cold weather).
The procedure is carried out under the effect of general anaesthesia. The surgery can be conducted through open heart or minimally invasive procedures.
Open heart: Your surgeon makes an incision around 2 inches from the elbow and 1 inch from the wrist to remove the radial artery. Then, a long incision is made in the middle of the chest and the breastbone is separated to gain access to the heart.
Minimally invasive: Three to four small incisions are made on the chest (instead of separating the breastbone) through which surgical instruments are inserted. Your surgeon may perform the surgery laparoscopically (fibre optic tube with camera and a light source is inserted to visually guide your surgeon) or robotically-assisted (use of surgeon-controlled robotic arms).
With either of the methods, your surgeon may stop the heart from beating by connecting your body’s circulation to a heart-lung bypass machine (on-pump surgery), or in some cases, may use an instrument to stabilize a small section of the heart where the bypass will be performed, while the rest of the heart continues to beat (off-pump surgery). A small opening is made in the aorta and one end of the radial artery is sutured to the aorta. Another incision is made past the blockage in the coronary artery, and the other end of the radial artery is sutured. Your surgeon then inspects the grafts to make sure they are working. The heart is disconnected from the heart-lung machine to resume pumping blood. The breastbone and chest incision are sutured and bandaged.
Plastic tubes are left in place to allow any drainage of excess blood from in and around the heart. The chest tubes are removed a day after the surgery. Your doctor will prescribe pain killers to relieve pain. You will be discharged from the hospital after about seven days and may recover completely in three months. It is important to adopt a healthy lifestyle following recovery, which would include:
Risks and Complications
Complications associated with radial artery surgery may include:
Benefits of radial artery grafts include: