Deep sternal infections after in situ bilateral internal thoracic artery grafting for left ventricular myocardial revascularization: predictors and influence on 20-year outcomes

Abstract

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Analysis of sternal healing after median sternotomy in low risk patients at midterm follow-up: retrospective cohort study from two centres

“…This method has been used for a long time; however, there is a 0.8–1.5% probability of sternal dehiscence or mediastinal infection after surgery [1]. The probability of sternal dehiscence or mediastinal infection could be as high as 2.4% after bilateral internal mammary artery grafting, thus leading to multiple complications and even death [2]. Shin reported that 34.5% of patients had poor sternal healing 3–6 months after surgery.…”

Influence of Internal Thoracic Artery Harvesting on Sternal Osteoblastic Activity and Perfusion

“…The main limitation of our study was that the unilateral and bilateral ITA harvesting was not compared. Several studies have been performed to investigate the clinical safety of bilateral ITA harvesting and its effect on the risk of deep sternal infection [ 22 , 23 , 24 , 25 ]. However, we found no works, especially randomized, evaluating the effect of bilateral ITA harvesting on sternal perfusion.…”

In situ skeletonized bilateral thoracic artery for left coronary circulation: a 20-year experience

“…Surgery was carried out as previously reported [12,13]. Indication and contraindication for BITA was also the same as we have recently reported [13]: in summary patients with a reasonable life expectancy (>1year), those requiring minimization of aortic manipulation and the presence of at least two angiographically branches of the left coronary circulation which were graftable were included.…”

“…Surgery was carried out as previously reported [12,13]. Indication and contraindication for BITA was also the same as we have recently reported [13]: in summary patients with a reasonable life expectancy (>1year), those requiring minimization of aortic manipulation and the presence of at least two angiographically branches of the left coronary circulation which were graftable were included. Contraindications were: poorly controlled diabetes (defined as an uninterrupted HbA1c >8.0% for ≥1 year despite standard care [14], class III obesity, evolving or acute (6 hours to 7 days) myocardial infarction.…”

“…Postoperatively, careful control of the glycemic values was undertaken by employing continuous insulin infusion, giving certain consideration to the higher risk of deep sternal wound infection in BIMA employment [13] Statistical Analysis.…”