Internal mammary artery as a graft in obese patients

Abstract

Internal mammary artery as a graft in obese patientsTo the Editor, We greatly appreciate the authors for this really large patient pool study published in The Anatolian Journal of Cardiology (1). Reported results of this study related to obese patients confirm the existing clinical practice in our settings and the literature. Sternal dehiscence and sternal infections are commonly encountered complications in obese patients although underlying factors can differ (2, 3). One of the underlying factors is harvested internal mammary artery (IMA) (unilateral or bilateral) as coronary grafts (2-4). For this very reason, use of IMA in obese patients can be challenging and often conservatively denied. We were wondering if there was any significant difference between obese patient groups with IMA as a graft and without IMA in terms of wound infection or sternal dehiscence. There was also considerable difference in terms of bleeding between two groups as the authors stated. IMA can also be a reason for re-explorations due to bleeding postoperatively though it is undeniable for its excellent long-term patency rates (5). We find it really important to gather more information for further considerations on the issue. We would kindly ask the authors to share their valuable knowledge related the above-mentioned topics. 5. Biancari F, Mikkola R, Heikkinen J, Lahtinen J, Airaksinen KE, Juvonen T. Estimating the risk of complications related to re-exploration for bleeding after adult cardiac surgery: a systematic review and meta-analysis. Eur J