Skeletonization and harvest of the internal thoracic artery with an ultrasonic scalpel

Does Age at Operation Influence the Short- and Long-Term Outcomes of Off-Pump Coronary Artery Bypass Grafting?

“…The ITAs were harvested in a skeletonized fashion using a harmonic scalpel (Ethicon Endo-Surgery; Cincinnati, OH, USA). 16 After sys- Predictors of peri-and postoperative outcome events were analyzed using uni-and multivariate logistic regression models. The odds ratios (OR) and 95% confidence intervals (CI) for the association between patients' backgrounds and major complications were estimated.…”

Off-Pump Coronary Artery Bypass Grafting Revisited: Experience and Evidence from Japan

“…Higami, et al 6) reported a unique method of harvesting the internal thoracic artery (ITA) by using a harmonic scalpel. With the harmonic scalpel, the ITA can be skeletonized safely and efficiently by the "quick touch method" to remove fat tissue surrounding the ITA and by protein coagulation to divide the branches from the ITA.…”

Off-pump coronary artery bypass grafting using in situ bilateral skeletonized internal thoracic arteries

“…Higami and associates described ultrasonic ITA skeletonization and revealed its technical feasibility and advantages. 4,5 We also used the ultrasonic scalpel to harvest and skeletonize the ITAs according to Higami's method. In our experience, the ultrasonic scalpel improves technical ease, shortens the harvesting time, and increases the effective length and free fl ow of the ITAs.…”

“…Furthermore, Higami and colleagues demonstrated that complete ultrasonic skeletonization increased the effective length of the ITA and improved free fl ow through the bypass. 4,5 The ITA is the most reliable conduit; therefore, cardiovascular surgeons should discuss the most effective use of the bilateral ITAs. ITAs are grafted in various fashions according to the surgeon's experience; thus, the most effective ITA grafting model has not been established.…”