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Semi-skeletonized internal mammary artery grafts and sternal wound complications

Yongzhi Deng1, Karen Byth, Hugh S Paterson

  • 1Department of Cardiothoracic Surgery, Westmead Hospital, Australia.

Asian Cardiovascular & Thoracic Annals
|September 9, 2004
PubMed

Insights

This study identified risk factors for sternal wound complications after coronary artery surgery. Peripheral vascular disease, diet-controlled diabetes, and delayed sternal closure were key risks for overall complications.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Surgical Infections

Background:

  • Sternal wound complications are a significant concern following coronary artery bypass grafting (CABG).
  • The use of bilateral internal mammary arteries (BIMA) is common, but its association with sternal complications requires evaluation.
  • Understanding risk factors is crucial for preventing sternal wound complications.

Purpose of the Study:

  • To identify independent risk factors for sternal wound complications after myocardial revascularization using bilateral semi-skeletonized internal mammary arteries.
  • To compare the sternal wound complication rate of this technique with other harvesting methods.

Main Methods:

  • Prospective analysis of 751 patients undergoing coronary artery surgery from September 1994 to August 2002.
  • Data collected included patient demographics, comorbidities, surgical details, and postoperative outcomes.
  • Statistical analysis was performed to identify independent risk factors for sternal wound complications and sternal infection.

Main Results:

  • Overall sternal wound complications occurred in 5.9% of patients.
  • Independent risk factors for any sternal wound complication included peripheral vascular disease, diet-controlled diabetes, and delayed sternal closure.
  • Independent risk factors for sternal infection were diabetes, postoperative pulmonary complications, and postoperative stroke.
  • The complication rate using bilateral semi-skeletonized internal mammary artery conduits was comparable to other techniques.

Conclusions:

  • Peripheral vascular disease, diet-controlled diabetes, and delayed sternal closure are significant risk factors for sternal wound complications after CABG.
  • Diabetes, postoperative pulmonary complications, and stroke increase the risk of sternal infection.
  • Bilateral semi-skeletonized internal mammary artery grafting demonstrates a comparable sternal wound complication rate to other methods.

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