Effects of ultrasonic skeletonization on internal thoracic and gastroepiploic arteries for coronary artery bypass grafting

Matsumoto, Kazuhisa; Tsuneyoshi, Isao; Iguro, Yoshifumi; Kinjo, Tamahiro; Yotsumoto, Goichi; Ueno, Masahiro; Kanmura, Yuichi; Sakata, Ryuzo

doi:10.1016/j.ejcts.2006.07.024

Cited by 10 publications

(5 citation statements)

References 13 publications

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“…This result was to be expected as previous studies showing that the vasodilator action of atrial natriuretic peptide is endothelium-independent and associated with increased cellular levels of cGMP as a result of activation of a particulate rather than a soluble guanylate cyclase in smooth muscle cells [13,14]. Endothelium-independent action of carperitide is advantageous in operation theaters as the endothelium of bypass grafts are easily and frequently injured during harvest and anastomoses in coronary artery bypass surgery [15].…”

Section: Commentsupporting

confidence: 77%

Suppression of Graft Spasm by the Particulate Guanylyl Cyclase Activator in Coronary Bypass Surgery

Kinoshita

Tawa

Suzuki

et al. 2017

The Annals of Thoracic Surgery

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Section: Commentsupporting

confidence: 77%

Suppression of Graft Spasm by the Particulate Guanylyl Cyclase Activator in Coronary Bypass Surgery

Kinoshita

Tawa

Suzuki

et al. 2017

The Annals of Thoracic Surgery

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“…Although this study has not been included in our data synthesis, as it contains no clinical data, we felt it contained some important results. They provide the first evidence that ultrasonic skeletonization is probably more traumatic to endothelial function than a conventional harvesting technique [40], and concluded that those who perform skeletonization should only employ vasodilators whose mode of action is not reliant on intact endothelial function to improve graft patency in the early post operative period.…”

Section: Resultsmentioning

confidence: 99%

Skeletonization of radial and gastroepiploic conduits in coronary artery bypass surgery

Massey

Warren

Szczeklik

et al. 2007

J Cardiothorac Surg

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The use of a skeletonized internal thoracic artery in coronary artery bypass graft surgery has been shown to confer certain advantages over a traditional pedicled technique, particularly in certain patient groups. Recent reports indicate that radial and gastroepiploic arteries can also be harvested using a skeletonized technique. The aim of this study is to systematically review the available evidence regarding the use of skeletonized radial and gastroepiploic arteries within coronary artery bypass surgery, focusing specifically on it's effect on conduit length and flow, levels of endothelial damage, graft patency and clinical outcome. Four electronic databases were systematically searched for studies reporting the utilisation of the skeletonization technique within coronary revascularisation surgery in humans. Reference lists of all identified studies were checked for any missing publications. There appears to be some evidence that skeletonization may improve angiographic patency, when compared with pedicled vessels in the short to mid-term. We have found no suggestion of increased complication rates or increased operating time. Skeletonization may increase the length of the conduit, and the number of sequential graft sites, but no clear clinical benefits are apparent. Our study suggests that there is not enough high quality or consistent evidence to currently advocate the application of this technique to radial or gastroepiploic conduits ahead of a traditional pedicled technique.

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“…In the cardiac surgery field, it is currently used for radial, thoracic, and gastroepiploic artery harvesting, pericardial resections, and tissue dissection during redo cases. [2][3][4] In other surgical specialties its applications are widely diverse, from division of splenic vessels, to thoracic duct division, thoracoscopic sympathectomies, lung resections, hepatectomies, pancreatic resections, partial and total nephrectomies, varicocelectomies, and hysterectomies, among many others. It has been proved to be a safe tool in terms of hemostasis, even when used to divide large systemic arteries, such as the splenic artery, or the feeding arteries of pulmonary sequestrations.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic double aortic arch division with Harmonic scalpel: A case report

Laje

Martı́nez-Ferro

2007

The Journal of Thoracic and Cardiovascular Surgery

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double aortic arch incidentally found during the course of a thoracoscopic repair of a type III esophageal atresia was successfully repaired by dividing the nondominant arch with the Harmonic scalpel device (Ultrashears, Autosonix Ultrasonic System; Tyco Healthcare, Mansfield, Mass) on day 1 after birth. The association of double aortic arch and esophageal atresia has been reported many times in the literature 1 and has important implications, because a proper esophageal reconstruction can be achieved only after the vascular anomaly has been corrected.

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Effects of ultrasonic skeletonization on internal thoracic and gastroepiploic arteries for coronary artery bypass grafting

Abstract: Ultrasonic complete skeletonization with the harmonic scalpel may retain smooth muscle function of skeletonized grafts, whereas endothelial function of ultrasonic skeletonized grafts may be significantly compromised.

Cited by 10 publications

References 13 publications

Suppression of Graft Spasm by the Particulate Guanylyl Cyclase Activator in Coronary Bypass Surgery

Suppression of Graft Spasm by the Particulate Guanylyl Cyclase Activator in Coronary Bypass Surgery

Skeletonization of radial and gastroepiploic conduits in coronary artery bypass surgery

Thoracoscopic double aortic arch division with Harmonic scalpel: A case report

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