ABSTRACTBetween July 1992 and May 1994, 148 patients (18 females) underwent myocardial revascularization with a radial artery (RA) graft. The left RA was used in 97.3 of cases. All but two patients received at least one additional arterial conduit: 137 left and 59 right internal mammary arteries (IMA); 23 inferior epigastric arteries; and 21 right gastroepiploic arteries. Total arterial revascularization was achieved in 127 patients (85.8). An average of 3.0 anastomoses/patient were constructed, 2.8 of which were arterial. RA proximal anastomoses were placed on the IMA in 75 of cases, while direct anastomosis to the aorta (23.7) or to a saphenous vein (1.3) was performed in the remainder. When anastomosed to an IMA, the RA was subsequently infused intraluminally with 10 mg of papaverine (1 mg/mL). The target artery was the left anterior descending or one of its branches in 14.7 of cases, the circumflex system in 76.3, and the native right coronary or one of its branches in the remaining 9. An infusion of diltiazem (4 mg/hour) was started once the aorta was unclamped, and patients were maintained on oral diltiazem for 6 months postoperatively. Operative mortality was 1.4 (2 patients), with the additional late deaths from noncardiac causes. In one patient there was a prolonged serous drainage from the RA donor site. Of the 144 survivors 140 are asymptomatic. Follow‐up angiography demonstrated 100 early patency (<30 days, 41 patients), and 94 late patency (6 to 20 months, mean 14 months, 30/32 patients). This study suggests the RA can be used safely as an alternative to saphenous vein in coronary bypass surgery. These results are encouraging and warrant further clinical investigatio
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