Two questions on bilateral internal mammary artery usage.

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Grafting

Background:

• The single internal mammary artery graft to the left anterior descending artery is the established standard for coronary revascularization.
• Widespread adoption of bilateral internal mammary artery grafts is limited by concerns over postoperative sternal wound complications.

Purpose of the Study:

• To evaluate the evidence comparing the skeletonization technique with the conventional pedicled technique for harvesting internal mammary artery grafts.
• To assess the potential of the skeletonization technique to mitigate sternal wound complications in bilateral internal mammary artery grafting.

Main Methods:

• Review and analysis of existing scientific literature comparing skeletonized versus pedicled internal mammary artery harvesting techniques.
• Examination of data related to sternal wound complication rates and graft patency associated with each harvesting method.

Main Results:

• Skeletonization of the internal mammary artery has been proposed to preserve sternal microcirculation.
• This preservation may lead to a reduction in sternal wound complications compared to the conventional pedicled technique.

Conclusions:

• The skeletonization technique for internal mammary artery harvesting warrants further investigation as a method to reduce sternal wound complications.
• Evidence supports exploring skeletonization to increase the utilization of bilateral internal mammary artery grafts in coronary revascularization.