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Related Experiment Video

Updated: Apr 15, 2026

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
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Off-pump Bilateral Internal Thoracic Artery Grafting.

Kamales Kumar Saha1, Mandar M Deval2, Ajay Kumar3

  • 1Private practice, multiple private hospitals in Mumbai, India; Fortis S. L Raheja Hospital, Mumbai, India.

Heart, Lung & Circulation
|April 6, 2015
PubMed
Summary

Bilateral internal thoracic artery (BITA) grafting is safe for all coronary artery bypass grafting (CABG) patients, including high-risk individuals. This study found no deep sternal wound infections, demonstrating BITA

Keywords:
Anaortic off-pump CABGBilateral internal thoracic artery graftingCABG arterial graftCABG new technologyCoronary artery bypass graft CABGOff-pump surgery

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Surgical Outcomes

Background:

  • Bilateral internal thoracic artery (BITA) grafts offer long-term benefits in coronary artery bypass grafting (CABG).
  • Concerns regarding deep sternal wound infection often limit BITA use in high-risk patients (diabetic, obese, elderly, female).

Purpose of the Study:

  • To analyze early outcomes of BITA grafting.
  • To establish the safety and feasibility of routine BITA use in all CABG patients.

Main Methods:

  • Retrospective analysis of consecutive, unselected isolated CABG cases.
  • In-situ BITA grafting used for left anterior descending artery and as inflow for composite grafts.
  • Dual inflow technique with in-situ BITA allowed for vein graft bailout.

Main Results:

  • BITA was utilized in 95.35% (574/602) of patients.
  • Low incidence of early death (1.33%), stroke (0.5%), and reoperation for bleeding (0.17%).
  • No deep sternal wound infections occurred; superficial infections (1.5%) resolved with dressing.

Conclusions:

  • BITA grafting was safely performed in 95% of unselected off-pump CABG patients.
  • Excellent early results were achieved without major wound complications.
  • Off-pump CABG with BITA grafting can be routinely adopted with confidence.