Short Term Outcomes Of Pedicled Versus Skeletonized Internal Mammary Artery Grafts In Coronary Bypass Surgery

Abstract

Background: The left internal mammary artery (IMA) is considered the cornerstone for grafting the left anterior descending (LAD) coronary artery with Pedicled and skeletonized techniques are the most commonly used harvesting techniques. Objectives: The aim of this work is to study the short term clinical outcomes of both techniques. Patients and methods: 100 patients requiring open heart surgery for isolated elective coronary artery bypass graft (CABG) were enrolled in this study. The patients were divided into two groups, 50 patients underwent pedicled left (IMA) harvesting and 50 patients underwent skeletonized left (IMA) harvesting, and all the patients had a 3-month follow-up. Results: There was no significant difference in patients’ demographic data between groups. The pedicled group was associated with an increased rate of post operative drainage (pedicled group versus skeletonized group) (486.0 ± 321.99 versus 338.0 ± 241.29) (P-value <0.001). There was no significant difference between both groups in regard to the duration of ventilation, intensive care unit stay, and arrhythmia. There was no significant difference between both groups in regard to sternal wound complications at three months follow up. Conclusions: Pedicled left (IMA) and skeletonized left (IMA) short term outcomes are nearly equal except that the skeletonized technique is superior in regard to the amount of post operative drainage in comparison to the pedicled technique.

Keywords

• internal mammary artery; pedicled; skeletonized; cabg