Skeletonized versus pedicled harvesting of bilateral internal mammary artery in coronary artery bypass graft: A case control study
10.7507/1007-4848.201707035
- VernacularTitle:骨骼化与带蒂获取双侧乳内动脉行冠状动脉旁路移植术早期临床结果的病例对照研究
- Author:
ZHONG Zhaoji
1
;
HOU Jianfeng
1
;
FAN Hongguang
1
;
LI Haojie
1
;
XIE Yanbo
1
;
WANG Xiaoqi
1
;
ZHENG Zhe
1
;
GAO Ge
1
Author Information
1. Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Science, Beijing, 100037, P.R.China
- Publication Type:Journal Article
- Keywords:
Coronary artery bypass graft;
internal mammary artery;
skeletonized harvesting
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2018;25(2):128-132
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and efficacy of skeletonized and pedicled harvesting of bilateral internal mammary artery (BIMA) in coronary artery bypass graft (CABG) surgery. Methods From December 2015 to May 2017, 152 patients (128 males, 24 females, age of 56.5±6.8 years) underwent CABG using either skeletonized BIMA (s-BIMA group, n=73) or pedicled BIMA(p-BIMA group, n=79). The operative data and post-operative outcomes were analyzed in the s-BIMA group (61 males, 12 females, age of 56.6±7.0 years) and the p-BIMA group (67 males, 12 females, age of 56.3±6.7 years). Results There was no peri-operative mortality. There was no statistical difference in operative time, cardiopulmonary bypass time, aortic cross-clamp time or internal mammary artery graft flow between the two groups. One patient(1.4%) in the s-BIMA group suffered from severe sternal wound complication, which was major sternal wound complication. Five patients (6.3%) in the p-BIMA group suffered from sternal wound complications, including 1(1.3%) with severe complication and 4(5.1%) with minor complication. One(1.4%) patient in the s-BIMA group and 7 (8.9%) patients in the p-BIMA group suffered from chylothorax. The chest tube drainage significantly reduced in the s-BIMA group, both in postoperative day 1(P=0.000) and postoperative day 1-3 (P=0.001). CT angiography showed no stenosis of BIMA in both groups. Conclusion The use of skeletonized BIMA for CABG is safe and efficacious, with less sternal wound complications, chylothorax and chest tube drainage. Skeletonization should be suggested if BIMA is harvested in CABG.
