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Off‐pump Skeletonized Versus Pedicled Left Internal Mammary Artery Grafting: Mid‐term Results
Author(s) -
Sun Xiaotian,
Huang Jiechun,
Wang Wenshuo,
Lu Shuyang,
Zhu Kai,
Li Jun,
Lai Hao,
Guo Changfa,
Wang Chunsheng
Publication year - 2015
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12551
Subject(s) - medicine , artery , mammary artery , skeletonization , bypass grafting , surgery , cardiology , anatomy
A bstract Background Skeletonization of the internal mammary artery for single left internal mammary artery (LIMA) use remains controversial. We sought to elucidate the effect of different harvesting techniques applied in single LIMA grafting. Method Between January 2006 and January 2012, 982 patients undergoing off‐pump coronary artery bypass with pedicled LIMA conduits (P Group) and 928 patients undergoing the same operation with skeletonized LIMA conduits (S Group) were enrolled. The length and blood flow of the conduits, and in‐hospital and mid‐term outcomes with one‐year postoperative graft angiographic results were analyzed and compared between groups. Results Twenty‐five (2.7%) patients in the S group died in hospital, compared with 26 (2.6%) in the P group, with similar rates of sternal wound infection, chest wall pain, and low‐output syndrome. Although the length and blood flow of conduits were increased in the S Group, postoperative conduit patency was similar between groups (p = 0.470). During a median follow‐up of 32.2 months, the groups showed similar total survival (88.3 ± 3.2%, S Group; 85.5 ± 2.0%, P Group; p = 0.118) and cardiac event‐free survival (82.7 ± 3.3%, S Group; 80.3 ± 2.0%; P Group; p = 0.129), with similar postoperative complications. Conclusions Skeletonization of single LIMA has no extra benefit in early or mid‐term outcomes, suggesting no advantage over the pedicled technique. doi: 10.1111/jocs.12551 (J Card Surg 2015;30:494–499)