The Journal of Thoracic and Cardiovascular Surgery
Volume 135, Issue 1 , Pages 32-37 , January 2008

Sternal microcirculation after skeletonized versus pedicled harvesting of the internal thoracic artery: A randomized study

  • Hiroyuki Kamiya, MD

      Affiliations

    • Department of Cardiovascular Surgery, University of Heidelberg, Heidelberg, Germany
    • ,
  • Payam Akhyari, MD

      Affiliations

    • Department of Cardiovascular Surgery, University of Heidelberg, Heidelberg, Germany
    • ,
  • Andreas Martens, MD

      Affiliations

    • Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
    • ,
  • Matthias Karck, MD

      Affiliations

    • Department of Cardiovascular Surgery, University of Heidelberg, Heidelberg, Germany
    • ,
  • Axel Haverich, MD

      Affiliations

    • Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
    • ,
  • Artur Lichtenberg, MD

      Affiliations

    • Department of Cardiovascular Surgery, University of Heidelberg, Heidelberg, Germany
    • Corresponding Author InformationAddress for reprints: Artur Lichtenberg, MD, Department of Cardiac Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.

Received 5 April 2007 ,Revised 29 August 2007 ,Accepted 11 September 2007.

References 

  1. El OR, Paul E, Wong PS, et al. Mediastinitis in patients undergoing cardiopulmonary bypass: risk analysis and midterm results. J Cardiovasc Surg (Torino). 1997;38:595–600
  2. Kohli M, Yuan L, Escobar M, et al. A risk index for sternal surgical wound infection after cardiovascular surgery. Infect Control Hosp Epidemiol. 2003;24:17–25
  3. Grossi EA, Esposito R, Harris LJ, et al. Sternal wound infections and use of internal mammary artery grafts. J Thorac Cardiovasc Surg. 1991;102:342–346
  4. Cohen AJ, Lockman J, Lorberboym M, et al. Assessment of sternal vascularity with single photon emission computed tomography after harvesting of the internal thoracic artery. J Thorac Cardiovasc Surg. 1999;118:496–502
  5. Lorberboym M, Medalion B, Bder O, et al. 99mTc-MDP bone SPECT for the evaluation of sternal ischaemia following internal mammary artery dissection. Nucl Med Commun. 2002;23:47–52
  6. Parish MA, Asai T, Grossi EA, et al. The effects of different techniques of internal mammary artery harvesting on sternal blood flow. J Thorac Cardiovasc Surg. 1992;104:1303–1307
  7. Knobloch K, Lichtenberg A, Pichlmaier M, et al. Microcirculation of the sternum following harvesting of the left internal mammary artery. Thorac Cardiovasc Surg. 2003;51:255–259
  8. Knobloch K, Lichtenberg A, Pichlmaier M, Tomaszek S, Krug A, Haverich A. Palmar microcirculation after harvesting of the radial artery in coronary revascularization. Ann Thorac Surg. 2005;79:1026–1030
  9. Boylan MJ, Lytle BW, Loop FD, et al. Surgical treatment of isolated left anterior descending coronary stenosis (Comparison of left internal mammary artery and venous autograft at 18 to 20 years of follow-up). J Thorac Cardiovasc Surg. 1994;107:657–662
  10. Lytle BW, Blackstone EH, Loop FD, et al. Two internal thoracic artery grafts are better than one. J Thorac Cardiovasc Surg. 1999;117:855–872
  11. Peterson MD, Borger MA, Rao V, Peniston CM, Feindel CM. Skeletonization of bilateral internal thoracic artery grafts lowers the risk of sternal infection in patients with diabetes. J Thorac Cardiovasc Surg. 2003;126:1314–1319
  12. 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;129:536–543
  13. Bical OM, Khoury W, Fromes Y, et al. Routine use of bilateral skeletonized internal thoracic artery grafts in middle-aged diabetic patients. Ann Thorac Surg. 2004;78:2050–2053
  14. Fokin AA, Robicsek F, Fokin A, Anderson JE. Changes in sternal blood flow after different methods of internal thoracic artery harvesting. Thorac Cardiovasc Surg. 2004;52:334–337
  15. Gottrup F. Oxygen in wound healing and infection. World J Surg. 2004;28:312–315
  16. Pevni D, Mohr R, Lev-Run O, Locer C, Paz Y, Kramer A, et al. Influence of bilateral skeletonized harvesting on occurrence of deep sternal wound infection in 1000 consecutive patients undergoing bilateral internal thoracic artery grafting. Ann Surg. 2003;237:277–280

PII: S0022-5223(07)01507-3

doi: 10.1016/j.jtcvs.2007.09.004

The Journal of Thoracic and Cardiovascular Surgery
Volume 135, Issue 1 , Pages 32-37 , January 2008

Article Tools

* Image Usage & Resolution