Routine Use of Unilateral and Bilateral Radial Arteries for Coronary Artery Bypass Graft Surgery

AbstractObjectives. This study sought to evaluate the routine use of radial artery (RA) grafts in patients undergoing coronary artery revascularization.Background. Previous long-term studies have documented poor patency of saphenous vein grafts compared with internal thoracic artery (ITA) grafts.Methods. We performed a prospective review of 175 of 249 consecutive patients.Results. Fifty-four patients had bilateral RAs harvested. Mean number (±SD) of grafts/patient was 3.27 ± 0.93, with 2.76 ± 0.97 arterial grafts; a mean of 1.53 ± 0.68 grafts were performed with the RA. The operative mortality rate was 1.6%. No deaths were related to RA grafts, and there were no RA harvest site hematomas or infections. Transient dysesthesia 1 day to 4 weeks in duration occurred in the distribution of the lateral antebrachial cutaneous nerve in six extremities (2.6%). Elective cardiac catheterization in 60 patients at 12 weeks postoperatively demonstrated a 95.7% patency rate.Conclusions. Because of potential benefit of long-term patency associated with arterial grafts, minimal morbidity and mortality associated with use of the RA and excellent short-term patency rates, we cautiously recommend use of one or both RAs as additional conduits to be used concomitantly with the ITA for arterial revascularization of the coronary arteries

742-4 Radial Artery Graft: Angiographic Follow-up

Interest in the use of the radial artery (RA) as a coronary bypass graft has increased. Attention to harvesting and use of perioperative calcium channel inhibitors have ameliorated problems with spasm noted in earlier studies. Since 1993, 72 patients (pts) underwent grafting using a free RA from the non-dominant forearm. Re-angiography was performed in 24 pts to date and is the subject of this study. Pts ranged from 39–79 years (mean 55.5); all had 2 or 3 vessel disease and an average of 3 grafts/pt were constructed (range 2–4). Left internal thoracic artery (L1TA) was used in all cases except 1. The RA was a single graft in 19 including 2 to the LAD system, 12 to the circumflex system and 5 to the RCA. The RA-was sequential in 5 cases. Of the 24 pts catheterized an average of 9 weeks post-op 24/24 RA's were patent: 1 (sequential) RA had a mid-graft stenosis. There was no spasm seen in any RA. RA distal diameters (2.6mm) were well matched to the recipient vessel (RV) (2.2mm). The ratio RV/graft diameter was 0.83 for the radial artery similar to the ratio for the L1TA (0.90).ConclusionThe RA is a viable coronary conduit, easily harvested and has excellent early patency rates

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead