INTRODUCTION: With the growing use of the radial artery as a coronary artery bypass graft, becomes necessary to revalue the criteria used for the selection of that vessel in the preoperative of the surgery of coronary artery bypass graft (CABG). The objective of this study was to correlate the evaluation of the viability of the vessel for the heart surgeon at surgery with the study of selection of the radial artery for the methods non invasivos, as EchocolorDoppler(ECD) and the digital photoplethysmography(PPG). METHODS: Between July of 1998 and January of 2000, 78 radial arteries and 78 arteries ulnares of 39 patients selected for CABG, were studied. The study was carried out bilaterally, using duplex ultrasound ATL - HDI 5000 and Acuson - Sequoia 512, and for the photoplethysmography an apparel Parks Vascular Mini - Lab Model 1052-C. The radial artery was considered susceptible to be used as coronary artery graft bypass, when it filled out the following criteria: ateromatose absence or occlusion of the radial artery and ulnar ipsilateral, internal diameter of the larger radial artery or equal to 2.5mm, appraised for ECD, and presence of pulse wave in two or more digits during the radial compression, appraised for the PPG. RESULTS: Among the 78 studied radial arteries, 64 (82%) were considered appropriate for use as coronary artery graft bypass and 12 (18.7%), not appropriate. Of the 39 selected patients, 24 (61.5%) they were submitted to CABG with use of the radial artery and the correlation between the viability of the appraised radial artery for the surgeon at surgery with the evaluation preoperative for ECD and for the PPG for selection of the radial artery was of 100%. The contraindication of the harvest of 12 (18.7%) radial arteries took to the alteration of the surgical planning of two patients, owing to the bilateral compromising. In three patients that, for different reasons, they were not submitted to the study by ECD and for the PPG, the clinical evaluation of the patency of the radial artery using Allen's maneuver was not enough to move away the presence of calcification of the arterial wall found in the operative act, disabling the use of that artery as graft. CONCLUSION: The selection of the radial artery for use as graft coronary artery bypass, appraised by non invasive tests, as ECD and the PPG, it is effective, because the association of those methods presents excellent correlation with the evaluation at surgery and it allows us, cardiovascular surgeons, besides the safety, a better surgical planning for each patient.
Radial artery; Echocardiography, Doppler color; Photoplethysmography; Myocardial revascularization
