Skeletonized bilateral internal mammary artery harvesting with harmonic scalpel in coronary artery bypass grafting_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YUAN Wei ,  WU Haibo

Department of Cardiac Surgery, The Second Hospital of Dalian Medical University, Dalian, 116000, P.R.China;

Corresponding author：

WU Haibo, Email: 1239247061@qq.com

Keywords：

Bilateral internal mammary artery; coronary artery bypass grafting; skeletonized; harmonic scalpel; surgery

DOI：

10.7507/1007-4848.202006076

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Objective To summarize the use of harmonic scalpel to harvest bilateral internal mammary artery in coronary artery bypass grafting (CABG). Methods The clinical data of 54 patients of bilateral skeletonized internal mammary artery harvesting for CABG in our hospital from January 2016 to May 2020 were analyzed retrospectively. There were 51 males and 3 females with a mean age of 62.37±9.56 years. Results All patients went through the procedure unevently and discharged from hospital. The number of grafts was 4.07±0.85 per patient, the operation time was 267.21±47.00 min, mechanical ventilation time was 342.43±132.17 min and hospital stay was 12.21±4.43 d. Conclusion It is safe and effective to use harmonic scalpel to harvest skeletonized bilateral internal mammary artery in CABG.

Citation： YUAN Wei, WU Haibo. Skeletonized bilateral internal mammary artery harvesting with harmonic scalpel in coronary artery bypass grafting. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(2): 214-218. doi: 10.7507/1007-4848.202006076 Copy

1.	Yoshikai M, Ito T, Kamohara K, et al. Endothelial integrity of ultrasonically skeletonized internal thoracic artery: morphological analysis with scanning electron microscopy. Eur J Cardiothoracic Surg, 2004, 25(2): 208-211.
2.	Ferrari ER, von Segesser LK. Arterial grafting for myocardial revascularization: how better is it? Curr Opin Cardiol, 2006, 21(6): 584-588.
3.	Raja SG, Benedetto U. Scoring system to guide decision making for the use of bilateral internal mammary arteries: The BIMA score. Int J Surg, 2018, 51: 89-96.
4.	Pevni D, Mohr R, Paz Y, et al. Long-term outcome of revascularization with composite T-grafts: Is bilateral mammary grafting better than single mammary and radial artery grafting? J Thorac Cardiovasc Surg, 2016, 151(5): 1311-1319.
5.	Navia D, Vrancic M, Piccinini F, et al. Is the second internal thoracic artery better than the radial artery in total arterial off-pump coronary artery bypass grafting? A propensity score-matched follow-up study. J Thorac Cardiovasc Surg, 2014, 147(2): 632-638.
6.	Kolh P, Windecker S, Alfonso F, et al. 2014 ESC/EACTS guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur J Cardiothorac Surg, 2014, 46(4): 517-592.
7.	Hillis LD, Smith PK, Anderson JL, et al. 2011 ACCF/AHA guideline for coronary artery bypass graft surgery. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons. J Am Coll Cardiol, 2011, 58(24): e123-e210.
8.	Keeley A. Experimental background of myocardial revascularization by internal mammary artery implantation and supplementary techniques, with its clinical applications in 125 patients. Ann Thorac Surg, 1987, 159: 185.
9.	Takami Y, Ina H. Effects of skeletonization on intraoperative flow and anastomosis diameter of internal thoracic arteries in coronary artery bypass grafting. Ann Thorac Surg, 2002, 73(5): 1441-1445.
10.	Higami T, Kozawa S, Asada T, et al. Skeletonization and harvest of the internal thoracic artery with an ultrasonic scalpel. Ann Thorac Surg, 2000, 70(1): 307-308.
11.	Kamiya H, Akhyari P, Martens A, et al. Sternal microcirculation after skeletonized versus pedicled harvesting of the internal thoracic artery: a randomized study. J Thorac Cardiovasc Surg, 2008, 135(1): 32-37.
12.	Higami T, Maruo A, Yamashita T, et al. Histologic and physiologic evaluation of skeletonized internal thoracic artery harvesting with an ultrasonic scalpel. J Thorac Cardiovasc Surg, 2000, 120(6): 1142-1147.
13.	Kinoshita T, Asai T, Suzuki T, et al. Off-pump bilateral skeletonized internal thoracic artery grafting in elderly patients. Ann Thorac Surg, 2012, 93(2): 531-536.
14.	Hu X, Zhao Q. Skeletonized internal thoracic artery harvest improves prognosis in high-risk population after coronary artery bypass surgery for good quality grafts. Ann Thorac Surg, 2011, 92(1): 48-58.

1. Yoshikai M, Ito T, Kamohara K, et al. Endothelial integrity of ultrasonically skeletonized internal thoracic artery: morphological analysis with scanning electron microscopy. Eur J Cardiothoracic Surg, 2004, 25(2): 208-211.
2. Ferrari ER, von Segesser LK. Arterial grafting for myocardial revascularization: how better is it? Curr Opin Cardiol, 2006, 21(6): 584-588.
3. Raja SG, Benedetto U. Scoring system to guide decision making for the use of bilateral internal mammary arteries: The BIMA score. Int J Surg, 2018, 51: 89-96.
4. Pevni D, Mohr R, Paz Y, et al. Long-term outcome of revascularization with composite T-grafts: Is bilateral mammary grafting better than single mammary and radial artery grafting? J Thorac Cardiovasc Surg, 2016, 151(5): 1311-1319.
5. Navia D, Vrancic M, Piccinini F, et al. Is the second internal thoracic artery better than the radial artery in total arterial off-pump coronary artery bypass grafting? A propensity score-matched follow-up study. J Thorac Cardiovasc Surg, 2014, 147(2): 632-638.
6. Kolh P, Windecker S, Alfonso F, et al. 2014 ESC/EACTS guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur J Cardiothorac Surg, 2014, 46(4): 517-592.
7. Hillis LD, Smith PK, Anderson JL, et al. 2011 ACCF/AHA guideline for coronary artery bypass graft surgery. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons. J Am Coll Cardiol, 2011, 58(24): e123-e210.
8. Keeley A. Experimental background of myocardial revascularization by internal mammary artery implantation and supplementary techniques, with its clinical applications in 125 patients. Ann Thorac Surg, 1987, 159: 185.
9. Takami Y, Ina H. Effects of skeletonization on intraoperative flow and anastomosis diameter of internal thoracic arteries in coronary artery bypass grafting. Ann Thorac Surg, 2002, 73(5): 1441-1445.
10. Higami T, Kozawa S, Asada T, et al. Skeletonization and harvest of the internal thoracic artery with an ultrasonic scalpel. Ann Thorac Surg, 2000, 70(1): 307-308.
11. Kamiya H, Akhyari P, Martens A, et al. Sternal microcirculation after skeletonized versus pedicled harvesting of the internal thoracic artery: a randomized study. J Thorac Cardiovasc Surg, 2008, 135(1): 32-37.
12. Higami T, Maruo A, Yamashita T, et al. Histologic and physiologic evaluation of skeletonized internal thoracic artery harvesting with an ultrasonic scalpel. J Thorac Cardiovasc Surg, 2000, 120(6): 1142-1147.
13. Kinoshita T, Asai T, Suzuki T, et al. Off-pump bilateral skeletonized internal thoracic artery grafting in elderly patients. Ann Thorac Surg, 2012, 93(2): 531-536.
14. Hu X, Zhao Q. Skeletonized internal thoracic artery harvest improves prognosis in high-risk population after coronary artery bypass surgery for good quality grafts. Ann Thorac Surg, 2011, 92(1): 48-58.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Skeletonized bilateral internal mammary artery harvesting with harmonic scalpel in coronary artery bypass grafting

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