Skeletonized Internal Mammary Artery for Coronary Artery Bypass Grafting_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Eryong , SHI Yingkang , MENG Wei

Department of Thoracic and Cardiovascular Surgery,West China Hospital, Sichuan University, Chengdu 610041, P.R.China. E-mail:zey16@126.com;

Corresponding author：

Keywords：

Coronary artery bypass grafting; Skeletonized internal mammary artery; Cardiac surgery

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Objective To summarize the early outcomes and clinical experience in the use of skeletonized internal mammary artery(IMA) for coronary artery bypass grafting(CABG). Methods From January 2004 to June 2007, a total of 139 patients underwent CABG and received skeletonized arteries in this hospital. Results The number of distal anastomoses was 3.6±1.7,there was no sternal wound infection or thoracic cavity effusion. Two patients died (1.4%), the complications incidence was 5.8%(8/139) lung infections 3 cases, incision infections 2 cases, and low cardiac output syndrome 3 cases.All complications were well treated by using antibiotics, dressing change and positive inotrope, and the follow-up period was 2 to 34 months(20.6±5.9 months); 110 patients were followed up (80.3%). All living patients were free from angina after operation and showed I-II class heart function (New York Heart Association). Conclusion Using skeletonized IMA is? a safe and effective method in CABG.

Citation： ZHANG Eryong,SHI Yingkang,MENG Wei,GUO Yingqiang,CHENG Shusen. Skeletonized Internal Mammary Artery for Coronary Artery Bypass Grafting. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2007, 14(6): 415-. doi: Copy

1.	Yusuf S, Zucker D, Peduzzi P, et al. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration.Lancet, 1994, 344(8922):563-570.
2.	Lytle BW, Blackstone EH, Loop FD, et al. Two internal thoracic artery grafts are better than one.J Thorac Cardiovasc Surg, 1999,117(5):855-872.
3.	Jones EL, Lattouf OM, Weintraub WS. Catastrophic consequences of internal mammary artery hypoperfusion.J Thorac Cardiovasc Surg, 1989,98(5 Pt 2):902-907.
4.	Loop FD, Lytle BW, Cosgrove DM, et al. J. Maxwell Chamberlain memorial paper. Sternal wound complications after isolated coronary artery bypass grafting: early and late mortality, morbidity, and cost of care. Ann Thorac Surg, 1990,49(2):179-186.
5.	Mueller XM, Tinguely F, Tevaearai HT, et al. Pain pattern and left internal mammary artery grafting. Ann Thorac Surg, 2000, 70(6):2045-2049.
6.	Keeley SB. The skeletonized internal mammary artery. Ann Thorac Surg,1987,44(3):324-325.
7.	熊利华，华平，李佳，等.乳内动脉skeleton取材法在冠状动脉旁路移植术中的应用.中国胸心血管外科临床杂志，2007, 14(4): 252-255.
8.	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.
9.	Deja MA, Wo′s S, Gotba KS, et al. Intraoperative and laboratory evaluation of skeletonized versus pedicled internal thoracic artery.Ann Thorac Surg, 1999, 68(6):2164-2168.
10.	De Paulis R, de Notaris S, Scaffa R, et al.The effect of bilateral internal thoracic artery harvesting on superficial and deep sternal infection: The role of skeletonization. J Thorac Cardiovasc Surg, 2005, 129(3):536-543.
11.	Wimmer-Greinecker G, Yosseef-Hakimi M, Rinne T, et al. Effect of internal thoracic artery preparation on blood loss, lung function, and pain. Ann Thorac Surg, 1999, 67(4):1078-1082.
12.	Raja SG, Dreyfus GD. Internal thoracic artery: to skeletonize or not to skeletonize? Ann Thorac Surg,2005,79(5):1805-1811.
13.	李儒正,天野笃,广濑仁,等. 超声刀在骨骼化动脉血管桥采取中的应用.中国心血管病研究杂志, 2006,4(6):429-431.
14.	Higami T, Yamashita T, Nohara H, et al. Early results of coronary grafting using ultrasonically skeletonized internal thoracic arteries. Ann Thorac Surg, 2001,71(4):1224-1228.
15.	Nishida H, Tomizawa Y, Endo M, et al. Coronary artery bypass with only in situ bilateral internal thoracic arteries and right gastroepiploic artery. Circulation, 2001, 104(12 Suppl 1):I 76-I 80.
16.	Calafiore AM, Vitolla G, Iaco AL, et al. Bilateral internal mammary artery grafting: midterm results of pedicled versus skeletonized conduits.Ann Thorac Surg, 1999,67(6):1637-1642.

1. 　Yusuf S, Zucker D, Peduzzi P, et al. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration.Lancet, 1994, 344(8922):563-570.
2. 　Lytle BW, Blackstone EH, Loop FD, et al. Two internal thoracic artery grafts are better than one.J Thorac Cardiovasc Surg, 1999,117(5):855-872.
3. 　Jones EL, Lattouf OM, Weintraub WS. Catastrophic consequences of internal mammary artery hypoperfusion.J Thorac Cardiovasc Surg, 1989,98(5 Pt 2):902-907.
4. 　Loop FD, Lytle BW, Cosgrove DM, et al. J. Maxwell Chamberlain memorial paper. Sternal wound complications after isolated coronary artery bypass grafting: early and late mortality, morbidity, and cost of care. Ann Thorac Surg, 1990,49(2):179-186.
5. 　Mueller XM, Tinguely F, Tevaearai HT, et al. Pain pattern and left internal mammary artery grafting. Ann Thorac Surg, 2000, 70(6):2045-2049.
6. 　Keeley SB. The skeletonized internal mammary artery. Ann Thorac Surg,1987,44(3):324-325.
7. 　熊利华，华平，李佳，等.乳内动脉skeleton取材法在冠状动脉旁路移植术中的应用.中国胸心血管外科临床杂志，2007, 14(4): 252-255.
8. 　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.
9. 　Deja MA, Wo′s S, Gotba KS, et al. Intraoperative and laboratory evaluation of skeletonized versus pedicled internal thoracic artery.Ann Thorac Surg, 1999, 68(6):2164-2168.
10. 　De Paulis R, de Notaris S, Scaffa R, et al.The effect of bilateral internal thoracic artery harvesting on superficial and deep sternal infection: The role of skeletonization. J Thorac Cardiovasc Surg, 2005, 129(3):536-543.
11. 　Wimmer-Greinecker G, Yosseef-Hakimi M, Rinne T, et al. Effect of internal thoracic artery preparation on blood loss, lung function, and pain. Ann Thorac Surg, 1999, 67(4):1078-1082.
12. 　Raja SG, Dreyfus GD. Internal thoracic artery: to skeletonize or not to skeletonize? Ann Thorac Surg,2005,79(5):1805-1811.
13. 　李儒正,天野笃,广濑仁,等. 超声刀在骨骼化动脉血管桥采取中的应用.中国心血管病研究杂志, 2006,4(6):429-431.
14. 　Higami T, Yamashita T, Nohara H, et al. Early results of coronary grafting using ultrasonically skeletonized internal thoracic arteries. Ann Thorac Surg, 2001,71(4):1224-1228.
15. 　Nishida H, Tomizawa Y, Endo M, et al. Coronary artery bypass with only in situ bilateral internal thoracic arteries and right gastroepiploic artery. Circulation, 2001, 104(12 Suppl 1):I 76-I 80.
16. 　Calafiore AM, Vitolla G, Iaco AL, et al. Bilateral internal mammary artery grafting: midterm results of pedicled versus skeletonized conduits.Ann Thorac Surg, 1999,67(6):1637-1642.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Skeletonized Internal Mammary Artery for Coronary Artery Bypass Grafting

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