Infrared Thermographic Imaging of Chest Wall Perfusion in Patients Undergoing Coronary Artery Bypass Grafting

Abstract

Coronary artery disease represents a leading cause of death worldwide, to which the coronary artery bypass graft (CABG) is the main method of treatment in advanced multiple vessel disease. The use of the internal mammary artery (IMA) as a graft insures an improved long-term survival, but impairment of chest wall perfusion often leads to surgical site infection and increased morbidity and mortality. Infrared thermography (IRT) has established itself in the past decades as a non-invasive diagnostic technique. The applications vary from veterinary to human medicine and from head to toe. In this study we used IRT in 42 patients receiving CABG to determine the changes in skin surface temperature preoperatively, two hours, 24 h and 6 days after surgery. The results showed a significant and independent drop of surface temperature 2 h after surgery on the whole surface of the chest wall, as well as a further reduction on the left side after harvesting the IMA. The temperature returned to normal after 24 h and remained so after 6 days. The study has shown that IRT is sufficiently sensitive to demonstrate the known, subtle reduction in chest wall perfusion associated with IMA harvesting.

Pathological study of sternal osteomyelitis after median thoracotomy – A prospective cohort study

“…The common recommendation is the ligation of the branches close to the main trunk (skeletonization), to preserve the collateral circulation [9,10]. Harvesting the main source of blood supply to the sternum has been shown in different studies to decrease the vascularization, using laser doppler Flowmetry and remission spectrometry [11] or infrared thermography [12]. The skeletonization of the LIMA was proven in a meta-analysis to decrease the incidence of sternal wound infections [13].…”