Benefit of Partial Right-Bilateral Internal Thoracic Artery Harvesting in Patients at Risk of Sternal Wound Complications

Zeitani, Jacob; Peppo, Alfonso Penta de; Paulis, Ruggero De; Nardi, Paolo; Scafuri, Antonio; Nardella, Saverio; Chiariello, Luigi

doi:10.1016/j.athoracsur.2005.06.025

Cited by 9 publications

(6 citation statements)

References 24 publications

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“…OBESITY. Similar to the presentation of macromastia or a large chest circumference discussed above, obese patients may be subjected to increased tension across the median sternotomy incision [35,40]. The resulting sternal instability may predispose these patients to the development of postoperative sternal infection [2,8,16].…”

Section: Preoperative Risk Factors For Sternal Infectionmentioning

confidence: 97%

Section: Risk Factors For Sternal Complicationsmentioning

confidence: 99%

“…Three studies investigated risk factors for sternal complications; each used its own clinical definition [38][39][40]. DM was the only independent risk factor that was reported by more than one study [38,40]. However, because one of these studies failed to provide adequate detail regarding the study population, a meta-analysis on the significance of this risk factor was not possible [40].…”

Section: Risk Factors For Sternal Complicationsmentioning

confidence: 99%

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Risk Factors for Sternal Complications After Cardiac Operations: A Systematic Review

Balachandran

Lee

Denehy

et al. 2016

The Annals of Thoracic Surgery

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Early detection of patients at risk of sternal complications is essential to facilitate prevention and optimize timely intervention. A systematic review and meta-analysis was conducted to identify risk factors associated with sternal complications. The review included 17 full-text studies, of which 10 were entered into meta-analyses. Female gender, diabetes mellitus, obesity, bilateral internal mammary artery grafts, reoperation for postoperative complications, and blood product requirement were reported as significant predictors of sternal infection. The compilation of these risk factors may help to screen and stratify patients at risk of impaired sternal healing and warrants further investigation.

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Section: Preoperative Risk Factors For Sternal Infectionmentioning

confidence: 97%

Section: Risk Factors For Sternal Complicationsmentioning

confidence: 99%

Section: Risk Factors For Sternal Complicationsmentioning

confidence: 99%

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Risk Factors for Sternal Complications After Cardiac Operations: A Systematic Review

Balachandran

Lee

Denehy

et al. 2016

The Annals of Thoracic Surgery

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“…Bilateral ITA harvesting may lead to poor healing of sternum because of the destruction of the collateral circulation between sternal-intercostal, perforating-intercostal, and sternalperforating branches, 11 and this risk is known to be higher in diabetic patients. 12,13 Modifi ed techniques including skeletonization of ITA graft and partial ITA harvesting have been developed to prevent extensive sternal devascularization. 12,13 Partial ITA harvesting is theoretically superior to ITA skeletonization in sternal blood supply preservation but a composite graft is often required for lengthening.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 Modifi ed techniques including skeletonization of ITA graft and partial ITA harvesting have been developed to prevent extensive sternal devascularization. 12,13 Partial ITA harvesting is theoretically superior to ITA skeletonization in sternal blood supply preservation but a composite graft is often required for lengthening. The patency of the composite graft may be inferior to that of the ITA graft itself and varies according to the conduits used for lengthening.…”

Section: Discussionmentioning

confidence: 99%

A novel technique of coronary revascularization in porcelain aorta: Report of two cases

Lin

Haung

et al. 2008

Surg Today

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Severe atherosclerosis of the distal ascending aorta increases the risk of intraoperative stroke during coronary artery bypass. More than one in situ arterial graft is required to avoid aortic manipulation during proximal anastomosis. The application of bilateral internal thoracic arteries is a good choice, but it also carries the risk of sternal wound complications. Using a composite graft constructed with a partially harvested in situ right internal thoracic artery graft and another vascular conduit prevents extreme ischemia of the sternum. This study describes the experience of successful coronary revascularization using bilateral internal thoracic arteries and modified with a composite graft in two patients with a severely atherosclerotic ascending aorta.

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Sternotomy Techniques

Zeitani¹

2018

Plastic and Thoracic Surgery, Orthopedics and Ophthalmology

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Benefit of Partial Right-Bilateral Internal Thoracic Artery Harvesting in Patients at Risk of Sternal Wound Complications

Cited by 9 publications

References 24 publications

Risk Factors for Sternal Complications After Cardiac Operations: A Systematic Review

Risk Factors for Sternal Complications After Cardiac Operations: A Systematic Review

A novel technique of coronary revascularization in porcelain aorta: Report of two cases

Sternotomy Techniques

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