Deep Sternal Infection Following Bilateral Internal Thoracic Artery Grafting

2018 ◽  
pp. 33-37
Author(s):  
Andrea Perrotti ◽  
Giuseppe Gatti ◽  
Fiona Ecarnot ◽  
Sidney Chocron
Keyword(s):  
Internal Thoracic Artery ◽  
Sternal Infection ◽  
Bilateral Internal Thoracic Artery

scholarly journals Skeletonization of bilateral internal thoracic artery grafts lowers the risk of sternal infection in patients with diabetes

2003 ◽  
Vol 126 (5) ◽  
pp. 1314-1319 ◽  
Author(s):  
Mark D Peterson ◽  
Michael A Borger ◽  
Vivek Rao ◽  
Charles M Peniston ◽  
Christopher M Feindel
Keyword(s):  
Internal Thoracic Artery ◽  
Sternal Infection ◽  
Patients With Diabetes ◽  
Bilateral Internal Thoracic Artery

Incidence of Sternal Infection in Diabetic Patients Undergoing Bilateral Internal Thoracic Artery Grafting

2005 ◽  
Vol 80 (5) ◽  
pp. 1765-1772 ◽  
Author(s):  
Aziz U. Momin ◽  
Ranjit Deshpande ◽  
James Potts ◽  
Ahmed El-Gamel ◽  
Michael T. Marrinan ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Diabetic Patients ◽  
Sternal Infection ◽  
Bilateral Internal Thoracic Artery

scholarly journals The effect of bilateral internal thoracic artery harvesting on superficial and deep sternal infection: The role of skeletonization

2005 ◽  
Vol 129 (3) ◽  
pp. 536-543 ◽  
Author(s):  
Ruggero De Paulis ◽  
Stefano de Notaris ◽  
Raffaele Scaffa ◽  
Saverio Nardella ◽  
Jacob Zeitani ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Sternal Infection ◽  
Bilateral Internal Thoracic Artery

Bilateral internal thoracic artery (BITA) revascularisation: is off-pump or on-pump the appropriate procedure?

2012 ◽  
Vol 60 (S 01) ◽  
Author(s):  
F Kur ◽  
A Beiras-Fernandez ◽  
C Jurma ◽  
S Sadoni ◽  
S Michel ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Off Pump ◽  
Bilateral Internal Thoracic Artery

Midterm Results of Routine Bilateral Internal Thoracic Artery Grafting

2005 ◽  
Vol 6 (5) ◽  
pp. 348 ◽  
Author(s):  
A. Kramer ◽  
R. Mohr ◽  
O. Lev-Ran ◽  
R. Braunstein ◽  
D. Pevni ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Regression Analysis ◽  
Pulmonary Disease ◽  
Internal Thoracic Artery ◽  
Chronic Obstructive ◽  
Midterm Results ◽  
Obstructive Pulmonary Disease ◽  
Sternal Infection ◽  
Repeat Operation

Background: Skeletonized dissection of the internal thoracic artery (ITA) decreases the occurrence of sternal devascularization, thus decreasing the risk of postoperative sternal complications in patients undergoing bilateral ITA grafting. Methods: From April 1996 to July 1999, 1000 consecutive patients underwent bilateral skeletonized ITA grafting. Of the 770 male and 230 female patients, 420 were older than 70 years, and 312 had diabetes. Results: Operative mortality was 3.3%. Follow-up (4078 months) revealed 79 late deaths, and the Kaplan-Meier 6-year survival rate was 88%. Cox regression analysis revealed increased overall mortality (early and late) in patients with preoperative congestive heart failure (risk ratio [RR], 2.13; 95% confidence interval [CI], 1.31-3.45), in patients with peripheral vascular disease (RR, 5.52; 95% CI, 3.31-9.19), and in patients older than 70 years (RR, 2.18; 95% CI, 1.37-3.47). Early postoperative morbidity included sternal infection (2.2%), cerebrovascular accident (1.6%), and perioperative myocardial infarction (1%). Multiple regression analysis showed repeat operation (odds ratio [OR], 7.5; 95% CI, 1.77-31.6) and chronic obstructive pulmonary disease (OR, 3.6; 95% CI, 1.27-10.75) to be independent predictors of sternal infection. During follow-up, angina returned in 95 patients, 24 of whom required reintervention (20 cases of percutaneous balloon angioplasty and 4 reoperations). Postoperative coronary angiography performed in 87 patients revealed an ITA patency rate of 91%. Conclusions: Bilateral skeletonized ITA grafting is associated with satisfactory early and midterm results. We do not recommend the use of this surgical technique in patients with chronic obstructive pulmonary disease.

Sternal Wound Complications in Bilateral Internal Thoracic Artery Grafting: A Comparison of the Off-Pump Technique and Conventional Cardiopulmonary Bypass

2005 ◽  
Vol 8 (6) ◽  
pp. E456-E461
Author(s):  
Naz Bige Aydin ◽  
Tufan Sener ◽  
Ilknur Kiygil Kehlibar ◽  
Tansel Turkoglu ◽  
Osman Eren Karpuzoglu ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Internal Thoracic Artery ◽  
Wound Complications ◽  
Off Pump ◽  
Bilateral Internal Thoracic Artery

Comparison between Multivessel Stenting with Drug Eluting to the LAD and Bilateral Internal Thoracic Artery Grafting

2006 ◽  
Vol 9 (1) ◽  
pp. E522-E527 ◽  
Author(s):  
Itzhak Herz ◽  
Yaron Moshkovitz ◽  
Roni Braunstein ◽  
Gideon Uretzky ◽  
Einat Zivi ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Bilateral Internal Thoracic Artery ◽  
Drug Eluting

A Novel Subxiphoid Approach for Bilateral Internal Thoracic Artery Harvesting

2021 ◽  
pp. 155698452098106
Author(s):  
Hossein Amirjamshidi ◽  
Jude S. Sauer ◽  
Bryan Barrus ◽  
Peter A. Knight ◽  
Sunil M. Prasad
Keyword(s):  
Minimally Invasive ◽  
Porcine Model ◽  
Internal Thoracic Artery ◽  
Experimental Testing ◽  
Bypass Graft ◽  
Arterial Revascularization ◽  
Early Results ◽  
Tissue Manipulation ◽  
Bilateral Internal Thoracic Artery

Objective Bilateral internal thoracic artery (BITA) bypass can enable more complete arterial revascularization procedures. Minimally invasive cardiac surgery (MICS) can offer significant patient benefits. New minimally invasive technology for sternal retraction and tissue manipulation is needed to enable ergonomic and reliable minimally invasive ITA harvesting. The goal of this research was to develop technology and techniques, along with experimental testing and training models, for a sternal-sparing approach to in situ BITA harvesting through a small subxiphoid access site. Methods This study focused on optimizing custom equipment and methods for subxiphoid BITA harvesting initially in a porcine model (19 pig carcasses, 36 ITAs) and subsequently in 7 cadavers (14 ITAs). Results Fifty consecutive ITAs were successfully harvested using this remote access approach. The last 20 ITA specimens harvested from the porcine model were explanted and measured; the average length of the free ITA grafts was 12.8 ± 0.9 cm (range 10.8 to 14.2 cm) with a mean time of 23.3 ± 5.2 minutes (range 13 to 25 minutes) for each harvest. Conclusions Early results demonstrate that both ITAs can be reliably harvested in a skeletonized fashion in situ through sternal-sparing, small subxiphoid access in 2 experimental models. This innovative approach warrants further exploration toward facilitating complete arterial revascularization and the further adoption of minimally invasive coronary artery bypass graft surgery.

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