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Superiority of using bipolar radiofrequency energy for internal mammary artery harvesting
Thomas A Vassiliades1, Ned Cosgriff, Amy Denham
1Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia, USA. thomas.vassiliades@emoryhealthcare.org
Purpose:
The purpose of this study was to observe the acute effects of harvesting the porcine internal mammary artery using a novel bipolar (BP) radiofrequency energy device.
Description:
The internal mammary artery from 16 porcine subjects was harvested using monopolar electrosurgery, BP electrosurgery, ultrasonic coagulation, and mechanical dissection with clips. Segments were evaluated with respect to endothelial function and integrity and the strength of side-branch sealing.
Evaluation:
Adenosine triphosphate-induced relaxation was greatest with internal mammary artery segments harvested by bipolar electrosurgery in comparison with monopolar electrosurgery (p = 0.0271), ultrasonic coagulation in comparison with monopolar electrosurgery (p = 0.0047), and mechanical clipping in comparison with monopolar electrosurgery (p = 0.0381). The standard error of the mean failed to demonstrate any significant difference in epithelial disruption among the four treatment groups. Clips and bipolar electrosurgery exhibited the most secure ligations with burst pressures exceeding 350 mm Hg.
Conclusions:
Internal mammary artery segments harvested using a novel BP electrosurgery retained a greater degree of endothelial function when compared with monopolar electrosurgery and ultrasonic coagulation. Side-branch sealing with BP electrosurgery was as secure as mechanical clips.
