In the first surgery of its kind on the West Coast using minimally invasive endoscopic technology, heart surgeons at UCLA Medical Center successfully removed an artery from a 72-year-old male patient’s wrist to be used in heart bypass surgery.

“We’ve taken the technology currently used in obtaining the vein from the leg for bypass surgery and moved it up to the arm,� said Dr. Fardad Esmailian, associate professor of cardiothoracic surgery at the David Geffen School of Medicine at UCLA. The procedure is a called an endoscopic radial artery harvesting technique.

When the coronary arteries, or small blood vessels, that supply the heart with oxygen and nutrients become clogged, heart bypass surgery allows doctors to create a “detour� around the blocked part of the artery to restore full blood flow to the heart. Doctors typically create the bypass using the patient’s leg vein that runs from the ankle to the groin. A special endoscopic camera allows the surgeon to locate and extract the leg vein using a tiny, keyhole incision.

However, in some cases, doctors may need to harvest an artery from the patient’s arm. Traditionally, this meant making an approximately 10-inch incision along the length of the forearm. In contrast, the new technique allowed Esmailian and his team to use the same endoscopic camera techniques to obtain the artery from a tiny “wristwatch� incision — aptly named because the patient’s wristwatch will cover the scar.

“We are very excited about the benefits of this minimally invasive harvesting advancement,� Esmailian said. “As you can imagine, there is less pain for the patient, potentially less chance of sensory damage to the finger, potentially lower infection and wound healing problems, and better cosmetic results since there is no scar running up the arm. From the surgeon’s perspective, even though there is a minimal incision, it still allows us to get the maximum length of the vein or artery.�

According to Esmailian, the radial artery from the arm is used in more than 60 percent of the coronary artery bypass graft surgeries at UCLA. In general, any patient under age 80 who has the proper arterial anatomy can be a candidate for radial artery harvest. Many studies have shown that using arteries for bypass is superior to using veins in terms of long-term results.

More than half a million Americans undergo heart bypass surgery each year; it is the most frequently performed surgery in the United States.

Heart surgeons on the East Coast and in the Midwest are also evaluating similar techniques.