Overview
The goal of this clinical trial is to learn if a new way to prepare a radial artery graft during coronary artery bypass grafting (CABG) can improve outcomes for adults having this surgery. CABG is a heart surgery that uses a blood vessel to bypass blocked arteries in the heart. The radial artery is a blood vessel taken from the arm and used as a graft.
The new way combines two steps:
Fasciotomy: a small cut in the tissue around the graft to release pressure.
Predilation: gently filling the graft with a medicine solution to widen it and check for damage.
Researchers will compare this new way with the standard way of harvesting the radial artery.
The main questions it aims to answer are:
Does the new way lower the chance of death, heart attack, another procedure to restore blood flow through the graft, or graft failure within 1 year after surgery?
Does it improve blood flow and keep the radial artery graft open?
Is it safe?
Participants will:
Be adults scheduled to have CABG using a radial artery graft.
Be assigned by chance to one of two groups: the new way or the standard way.
Have CABG surgery.
Visit the clinic at 7 days, 30 days, 6 months, and 12 months after surgery.
Have a special heart scan (coronary computed tomography angiography, CCTA) at 7 days and 12 months to check the graft.
Allow researchers to collect medical information and record any health problems.
Researchers will compare the two groups to see if the new way works better than the standard way.
Eligibility
Inclusion Criteria:
- Scheduled for coronary artery bypass grafting (CABG) and planned use of radial artery (RA) grafts
Exclusion Criteria:
- Emergency CABG or redo CABG
- Planned concomitant cardiac or non-cardiac surgery
- Contraindications to coronary computed tomography angiography (CCTA), including pregnancy, uncontrolled severe iodine contrast allergy, or severe renal insufficiency (eGFR \< 30 mL/min/1.73 m²)
- Any condition that, in the investigator's judgment, would preclude safe participation, completion of informed consent, or follow-up
- Inability to provide written informed consent
