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| ID | Type | Description | Link |
|---|---|---|---|
| SGS25/LF/2023 | Other Grant/Funding Number | University of Ostrava |
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The skeletonization technique of left internal artery (LIMA) harvesting is reported as more spar-ing to the vascular supply of the sternum. Some studies report a greater length and greater flow of the graft additionally. The aim of our study was to measure the difference in post-op sternal blood supply compared to the pedicle harvesting technique and to measure the length and flow of the LIMA graft.
A total of 90 patients were examined in a prospective randomized study. In 60 patients referred for coronary artery bypass grafting (CABG), LIMA was harvested, one-half (n=30) skeletonized, and one-half (n=30) with a pedicle. Thirty patients operated via sternotomy without LIMA harvesting (other procedures, for instance, valve surgery) were the control group. In patients undergoing LIMA harvest, harvest duration, graft length, and graft free flow were measured at defined arterial pressure. In all patients, the sternal blood flow was examined by active dynamic thermography (DIRT): first preoperatively and on 4th postoperative day. During this, the time of spontaneous rewarming of the skin surface after the application of a cold stimulus was measured in the caudal part of the sternum. The difference between postoperative and preoperative time was calculated and compared between groups.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| LIMA - pedicle |
| ||
| LIMA - skeletonised |
| ||
| Control group - LIMA not harvested |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| The mammary artery harvesting by the pedicle technique | Procedure | The mammary artery harvesting by the pedicle technique was used in the LIMA pedicle study group. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Rewarming time difference | Duration of spontaneous rewarming of the skin surface of the caudal sternum after a cold stimulus, measured from 24°C to 27°C. Unit: seconds (s) | first preoperatively and on 4th postoperative day |
| Measure | Description | Time Frame |
|---|---|---|
| Duration of the mammary graft harvesting | Time from the start of the harvesting to complete graft release. Unit: minute (min). | during surgery, immediately after the graft harvesting |
| Length of the mammary artery graft |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients undergoing elective cardiac surgery via sternotomy
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| Name | Affiliation | Role |
|---|---|---|
| Radim Brát, Assoc.Prof.,MD,PhD,MBA | University Hospital Ostrava | Study Chair |
| Jiřà Sieja, MD | University Hospital Ostrava | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Ostrava | Ostrava | Moravial-Silesian Region | 70852 | Czechia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26410160 | Background | Cheng K, Rehman SM, Taggart DP. A Review of Differing Techniques of Mammary Artery Harvesting on Sternal Perfusion: Time for a Randomized Study? Ann Thorac Surg. 2015 Nov;100(5):1942-53. doi: 10.1016/j.athoracsur.2015.06.087. Epub 2015 Sep 26. | |
| 32885924 | Background | Alom S, Yang N, Bin Saeid J, Zeinah M, Harky A. Harvesting internal mammary artery: a narrative review. J Cardiovasc Surg (Torino). 2020 Dec;61(6):790-801. doi: 10.23736/S0021-9509.20.11216-3. Epub 2020 Sep 4. |
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There is no plan to make individual participant data available to other researchers.
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| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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| The mammary harvesting using the skeletonization technique | Procedure | The mammary harvesting using the skeletonization technique was used in the LIMA skeletonized study group. |
|
| No intervention | Procedure | No intervention was used in the control study group. |
|
Length from the distance of the graft from the chest wall to its distal end. Unit: millimeter (mm).
| during surgery, immediately after the graft harvesting |
| Free outflow of the mammary artery | After trimming the distal clip on the graft at an arterial pressure of 70 mmHg, free flow for 30 seconds, then multiplied by two. Unit: millilitre per minute (ml/min). | during surgery, just before the graft use |
| 34132753 | Background | Lamy A, Browne A, Sheth T, Zheng Z, Dagenais F, Noiseux N, Chen X, Bakaeen FG, Brtko M, Stevens LM, Alboom M, Lee SF, Copland I, Salim Y, Eikelboom J; COMPASS Investigators. Skeletonized vs Pedicled Internal Mammary Artery Graft Harvesting in Coronary Artery Bypass Surgery: A Post Hoc Analysis From the COMPASS Trial. JAMA Cardiol. 2021 Sep 1;6(9):1042-1049. doi: 10.1001/jamacardio.2021.1686. |