The use of skeletonized internal mammary artery for coronary artery bypass grafting / 解放军医学杂志

ABSTRACT

Objective To summarize the early and mid-term results and experience of skeletonized internal mammary artery (IMA) harvesting in coronary artery bypass grafting (CABG). Methods The clinical data of 56 patients (46 males and 10 females, aged 61.8±7.7 years) having undergone conventional CABG with skeletonized IMA harvesting from Jan. 2014 to Oct. 2015, were retrospectively reviewed. The patients' demographic information, major complications, perioperative related parameters and early postoperative results were collected and recorded. All the patients were followed up postoperative, and major adverse events were collected. Results 59 IMAs were harvested from 56 patients, including 55 left internal mammery artery (LIMA) and 4 right internal mammery artery (RIMA). Bilateral IMAs were harvested in 3 patients. The mean harvesting time was 55.5±13.0 minutes. According to the sequence of harvesting, all the patients were divided into group 1 (first 29 patients) and group 2 (later 27 patients). There was no significant difference in success rate of harvesting or graft flow between two groups (30.4±14.4ml/ min vs 30.3±16.0ml/min, P=0.986). The harvesting time was significantly shorter in group 2 than in group 1 (P=0.001). The mean number of anastomosis was 2.96±0.89. There was no hospital death and severe complications such as myocardial infarction, reexploration for bleeding, or deep wound infection, or non-union of the sternum. All patients were followed up for 1-23 months postoperatively. There was no death or any major adverse cardiovascular events during the follow-up period, except one patient died of acute pulmonary embolism 3 months postoperatively. Conclusion Skeletonized IMA harvesting can be safely and reliably applied to CABG with excellent early and mid-term results.