Document Detail

Should the diabetics have the internal thoracic artery skeletonized? Assessment of sternal perfusion by scintillography.
MedLine Citation:
PMID:  19768294     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess, by scintillography, the effect of using bilateral internal thoracic arteries (BITAs) - prepared by two different techniques - on the sternal perfusion.
METHODS: 35 patients undergone coronary artery bypass grafting (CABG) were divided into two groups: Group A (18) had both ITA's dissected using skeletonization technique and group B (17) as pedicle preparation. There was no difference in the two groups relating gender, age and demographic characteristics. On the 7th postoperative day the patients underwent bone scintillography. The statistical analysis was performed using the Student's t test with 95% significance.
RESULTS: Group A (skeletonized ITA) showed higher perfusion (11.5%) of the sternum as a mean, than Group B (pedicled ITA) patients; however this was not statistically significant (P = 0.127). On the other hand, comparing the diabetic population, seven in each group, there was a marked 47.4% higher perfusion of the sternum in Group A patients (skeletonized ITA) comparing to Group B (pedicled ITA) and this difference reached statistical significance (P = 0.004).
CONCLUSION: 1- Sternal perfusion is not affected significantly apart from the dissection technique used for both internal thoracic arteries in the general population when assessed by bone scintillography. 2 - In the diabetic subgroup, a significant preservation of the sternal perfusion was observed in patients undergone skeletonized dissection of the internal thoracic arteries. Although these findings should be confirmed in a greater number of cases, diabetic patients should have the internal thoracic arteries dissected using skeletonization techinque.
Edmilson Cardoso Dos Santos Filho; Fernando Ribeiro de Moraes Neto; Ricardo Augusto Machado E Silva; Carlos Roberto Ribeiro de Moraes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Revista brasileira de cirurgia cardiovascular : órgão oficial da Sociedade Brasileira de Cirurgia Cardiovascular     Volume:  24     ISSN:  1678-9741     ISO Abbreviation:  Rev Bras Cir Cardiovasc     Publication Date:    2009 Apr-Jun
Date Detail:
Created Date:  2009-09-21     Completed Date:  2010-02-22     Revised Date:  2012-04-02    
Medline Journal Info:
Nlm Unique ID:  9104279     Medline TA:  Rev Bras Cir Cardiovasc     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  157-64     Citation Subset:  IM    
Heart Institute of Pernambuco, RealHospital Português de Beneficência of Pernambuco, Recife, PE,Brazil.
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MeSH Terms
Chi-Square Distribution
Coronary Artery Bypass / methods*
Diabetes Mellitus*
Mammary Arteries / transplantation*
Middle Aged
Prospective Studies
Regional Blood Flow
Sternum / blood supply*,  radionuclide imaging

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