Effect of LIMA Harvesting Technique on Postoperative Drainage in Off-Pump CABG

Özülkü, Mehmet; Aygün, Fatih

doi:10.5935/1678-9741.20160024

Cited by 11 publications

(9 citation statements)

References 22 publications

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“…In a study by Ozulku and Aygun on 160 subjects underwent CABG, they found that the amount of drainage was higher in the pedicled group [21]. In our study, there were 16 patients who developed wound infection; two patients underwent sternal rewiring.…”

Section: Discussionsupporting

confidence: 42%

The outcomes of Skeletonized and Pedicled Internal Thoracic Artery in Patients undergoing coronary artery bypass grafting: a randomized clinical study

Shaheen

El-Shafiey

Hebishy³

et al. 2020

Egypt. Cardiothoracic. Surg.

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Background: Internal thoracic artery became the cornerstone graft in coronary artery bypass grafting. This study aimed to investigate sternal healing and wound infection in patients undergoing coronary artery bypass graft (CABG) surgery using skeletonized versus pedicled internal thoracic artery. Methods: 100 patients who underwent isolated CABG were divided into two groups; skeletonized internal thoracic artery (ITA) (50 patients) and pedicled internal thoracic artery (50 patients). The postoperative assessment was performed three months after surgery. Physical and radiological examinations were performed after surgery to assess sternal healing. Results: There was no significant difference in patients’ demographics between groups. Skeletonized group had more diabetic patients (65% vs 44%; p= 0.016). There was no significant difference between the two groups regarding the number of grafts (2.72 ± 0.89 vs. 2.68 ± 0.90; skeletonized vs pedicled group; p= 0.84). Harvesting time was longer in the skeletonized group (55.69 ± 8.80 vs. 44.28 ± 6.95 minutes; p=0.09). Superficial wound infection occurred more frequently in the pedicled group (24% vs. 8%; p=0.03). Conclusion: Skeletonization of the internal thoracic artery conduits lowers the risk of superficial and deep sternal wound infection in patients undergoing CABG compared to the pedicled technique. However, skeletonization of internal thoracic artery conduits prolongs the operation time and requires more surgical skills.

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Section: Discussionsupporting

confidence: 42%

The outcomes of Skeletonized and Pedicled Internal Thoracic Artery in Patients undergoing coronary artery bypass grafting: a randomized clinical study

Shaheen

El-Shafiey

Hebishy³

et al. 2020

Egypt. Cardiothoracic. Surg.

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“…LITA is the most commonly used arterial graft in CABG accounting for its satisfactory patency rate, convenience for coronary artery anastomosis when it does not need proximal anastomosis. The importance of LITA graft use was emphasized in numerous reports, and the LITA graft use had proven to decrease the mortality rates and increase long-term survival in both male and female CABG patients [ 30 - 32 ] . Therefore, LITA as coronary bypass graft in our practice is commonly preferred.…”

Section: Discussionmentioning

confidence: 99%

Are the Early Postoperative Outcomes of Coronary Artery Bypass Grafting Surgery in Elderly Women Worse Compared to Men's?

Yüksel¹,

Kan²,

Yolgösteren³

et al. 2017

Braz J Cardiovasc Surg

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ObjectiveTo investigate the impact of gender difference in early postoperative outcomes in elderly patients (aged 70 or older) undergoing coronary artery bypass grafting surgery.MethodsBetween October 2009 and December 2013, a total of 223 elderly patients (aged 70 or older) undergoing isolated primary coronary artery bypass grafting surgery were included in this retrospective observational cohort study. Patients were divided into two groups according to their gender. The patients' medical records were collected, their baseline preoperative characteristics, operative data, and postoperative outcomes were retrospectively reviewed, and the effect of gender difference in the early postoperative outcomes was analyzed.ResultsGroup 1 (female patients) and Group 2 (male patients) consisted of 71 and 152 patients, respectively. Mean age of patients was 74.4±3.6 years (range: 70-84 years). The level of EuroSCORE I, the incidence of hypertension and hyperlipidemia were significantly higher in Group 1, while the rate of smoking was significantly higher in Group 2. Mean postoperative intubation time, length of intensive care unit and hospital stay were longer in female patients than in male patients, but these differences were not statistically significant. No statistically significant difference between two groups in terms of the transfusion of blood products was observed. The rates of in-hospital mortality and major postoperative complications were statistically similar between the two groups.ConclusionIn conclusion, the female gender was not associated with worse early postoperative outcomes in elderly patients undergoing coronary artery bypass grafting surgery.

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“…The reason for poor and inconsistent LIMA blood flow after topical application of papaverine alone in pedicled LIMA (1–1.5 cm) is the presence of thick tissue comprised of an intrathoracic fascia, adipose tissue, and muscle around the LIMA preventing the adequate contact of the conduit with the vasodilator. [ 16 ] Several investigators, Mulay et al . [ 17 ] and Girard et al .…”

Section: Discussionmentioning

confidence: 99%

Quantitative estimation of LIMA blood flow between extraluminal papavarine vs extraluminal papavarine plus intraluminal vasodilator cocktail in CABG patients

2020

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Objective: In this study, we aimed at a comparative quantitative estimation of the difference in LIMA blood flow between LIMAs treated with topical papaverine alone and LIMAs treated with a combination of topical papaverine plus an intraluminal cocktail of papaverine, nitroglycerine, and milrinone. Methods: Nearly 50 consecutive patients with similar demographics undergoing elective on-pump CABG were recruited for the study. After pedicled LIMA harvest, topical papaverine was sprayed on the pedicle and kept enveloped in papaverine soaked gauze. LIMA flow was then estimated. Later, intraluminal vasodilator solution of papaverine, NTG, milrinone, and heparinized blood were instilled in LIMA, and LIMA flows were estimated. Results: The mean LIMA flows with topical papaverine alone was 47.19 mL/min whereas the mean LIMA flows with topical papaverine plus intraluminal cocktail was 104 mL/min. There was a significant difference between the two flows as their mean was 56.815 mL/min and the paired t -test for significance had a P value of 0.0001. Conclusion: There was a significant difference in the LIMA flow when the LIMA had been treated with the intraluminal instillation of the vasodilator cocktail in addition to the topical application of papaverine solution. Therefore, intraluminal vasodilator cocktail of milrinone, NTG, and papaverine mixed with heparinized blood in addition to topical papaverine is a simple and effective method for LIMA preparation in CABG.

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Effect of LIMA Harvesting Technique on Postoperative Drainage in Off-Pump CABG

Cited by 11 publications

References 22 publications

The outcomes of Skeletonized and Pedicled Internal Thoracic Artery in Patients undergoing coronary artery bypass grafting: a randomized clinical study

The outcomes of Skeletonized and Pedicled Internal Thoracic Artery in Patients undergoing coronary artery bypass grafting: a randomized clinical study

Are the Early Postoperative Outcomes of Coronary Artery Bypass Grafting Surgery in Elderly Women Worse Compared to Men's?

Quantitative estimation of LIMA blood flow between extraluminal papavarine vs extraluminal papavarine plus intraluminal vasodilator cocktail in CABG patients

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