Randomized Comparison of Skeletonized Versus Pedicled Left Internal Thoracic Artery

Randomized Comparison of HARVesting the Left Internal Thoracic Artery in a Skeletonized Versus Pedicled Technique: the HARVITA Trial

Internal thoracic arteries can be harvested in skeletonized or pedicled technique. Latest research has posed a potential adverse effect of skeletonizing the internal thoracic arteries on graft patency rates and clinical outcome. Prospective, randomized, multi-centre trials are necessary to investigate the impact of harvesting technique of left internal thoracic artery (LITA) on graft patency rates and clinical outcome after coronary artery bypass grafting.

The HARVITA trial compares skeletonized and pedicled harvesting technique of LITA regarding graft patency rates and patient survival.

Inclusion criteria:

Primary isolated CABG patients with multi-vessel disease (defined as ≥70 % stenosis of the left anterior descending artery (LAD) and ≥50% stenosis of circumflex and right coronary territory, with or without a ≥50% stenosis of the left main artery).

Exclusion criteria:

• Age > 80 years
• Planned CABG without LITA use
• Preoperative mediastinal radiation therapy
• Emergency operation
• Minimal invasive coronary artery bypass surgery
• Any concomitant cardiac or non-cardiac procedures
• Previous cardiac surgery
• Known contrast agent allergy
• Severe stenosis of the left subclavian artery/ left-sided subclavian steal syndrome
• Chronic kidney disease (GFR <60ml/min/1.73m²)
• Life expectancy of less than 5 years
• Pregnancy
• Hyperthyroidism
• Iodine allergy

Intraoperative exclusion criteria:

• Y/T graft off the LITA graft
• LITA sequential grafting
• LITA target vessel other than LAD