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Should the diabetics have the internal thoracic artery skeletonized? Assessment of sternal perfusion by

Edmilson Cardoso Dos Santos Filho1, Fernando Ribeiro de Moraes Neto, Ricardo Augusto Machado E Silva

  • 1Heart Institute of Pernambuco, RealHospital Português de Beneficência of Pernambuco, Recife, PE,Brazil.

Revista Brasileira De Cirurgia Cardiovascular : Orgao Oficial Da Sociedade Brasileira De Cirurgia Cardiovascular
|September 22, 2009
PubMed

Insights

Skeletonized internal thoracic arteries (ITAs) show improved sternal perfusion in diabetic patients undergoing coronary artery bypass grafting (CABG). This technique may preserve sternal blood flow in this high-risk group.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Medical Imaging

Background:

  • Sternal perfusion is crucial for healing after coronary artery bypass grafting (CABG).
  • Internal thoracic arteries (ITAs) are commonly used grafts in CABG.
  • Dissection techniques for ITAs may impact sternal blood supply.

Purpose of the Study:

  • To evaluate the effect of two ITA preparation techniques on sternal perfusion using scintigraphy.
  • To compare sternal perfusion between skeletonized and pedicled ITA dissections in CABG patients.

Main Methods:

  • 35 CABG patients were divided into two groups: skeletonized ITAs (Group A) and pedicled ITAs (Group B).
  • Bone scintigraphy was performed on postoperative day 7 to assess sternal perfusion.
  • Statistical analysis utilized the Student's t-test with 95% significance.

Main Results:

  • Overall sternal perfusion was higher in the skeletonized ITA group (Group A) but not statistically significant (P=0.127).
  • In diabetic patients, sternal perfusion was significantly higher (47.4%) in the skeletonized ITA group (Group A) compared to the pedicled ITA group (Group B) (P=0.004).

Conclusions:

  • Sternal perfusion is not significantly affected by ITA dissection technique in the general CABG population.
  • Skeletonized ITA dissection significantly preserves sternal perfusion in diabetic patients.
  • Diabetic patients undergoing CABG may benefit from skeletonized ITA dissection to enhance sternal perfusion.
Abstract

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