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Changes in sternal blood flow after different methods of internal thoracic artery harvesting
A A Fokin1, F Robicsek, A Fokin
1Department of Thoracic and Cardiovascular Surgery, Heineman Medical Research Laboratories, Carolinas Medical Center, 1001 Blythe Boulevard, Charlotte, NC 28203, USA.
Objective:
The study was designed to assess the early changes in sternal perfusion after midline sternotomy and different (skeletonized versus semiskeletonized) techniques of internal thoracic artery (ITA) harvesting.
Methods:
The experiments were performed in the swine model. After midline sternotomy, ITA harvesting (skeletonized technique) was performed unilaterally in Group I (6 animals). The ITA and the internal thoracic vein (ITV) were harvested (semiskeletonized technique) in Group II (5 animals). The contralateral sternal half served as a control. Using a thermographic camera with a 0.06 degrees C sensitivity, sternal perfusion was assessed 2 and 5 hours after surgery.
Results:
Midline sternotomy alone did not affect sternal blood flow. A statistically significant ( p < 0.05) reduction in perfusion of the involved sternal half in comparison to the control side was detected at 2 and 5 hours after surgery. The degree of perfusion deficit was not related to the harvesting technique.
Conclusions:
Skeletonized and semiskeletonized ITA harvesting techniques caused a similar acute reduction in sternal perfusion during the early postoperative period and this effect lasted for at least 5 hours.
