ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Effect of Skeletonization on Flow and Length of Internal Thoracic Artery
Tamer Türk, Osman Tiryakioğlu, Ahmet Hakan Vural, Yusuf Ata, Özer Selimoğlu, Şenol Yavuz
Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp Damar Cerrahisi Kliniği, Bursa
Backgorund: The internal thoracic artery (ITA) is the best conduit of choice for surgical treatment of coronary artery disease. Skeletonization of this arterial conduit seems to improve the graft length, flow and allow constructing sequential anastomoses. In this study length and blood flow of both pedicled and skeletonized forms of ITA are compared on the same conduits.

Methods: Totaly 52 patients underwent coronary artery bypass grafting with the use of skeletonized left internal thoracic artery (LITA). LITA was harvested with a pedicle and papaverine was sprayed over the LITA, after that length and flow of pedicled LITA were measured. At the second step the LITA was skeletonized from the pedicle and papaverine was sprayed over the skeletonized LITA and the second measurements of length and flow were done.

Results: The length of pedicled LITA was 16.8 ± 0.7 cm. versus 18.9 ± 0.5 cm in skeletonized form (p < 0.001). The free blood flow was 59.4 ± 5.4 ml. in pedicled LITA versus 96.3 ± 5.3 ml in the skeletonized form (p < 0.001). There were no LITA grafts that are not grafted because of insufficient length or insufficient flow.

Conclusion: Skeletonization of the LITA results in significantly higher blood flow and available length of the graft. This reduces the risk of LITA hypoperfusion syndrome and improved length of the conduit allows more distal coronary artery anastomoses.

Keywords : Coronary surgery, internal thoracic artery, skeletonization
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