Document Detail


Skeletonized and pedicled internal thoracic artery grafts: effect on free flow during bypass.
MedLine Citation:
PMID:  8619716     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The skeletonization technique of the internal thoracic artery (ITA) is used as a dissection technique for myocardial revascularization procedures. This study compared free flow between skeletonized ITA grafts and ITA pedicled grafts. METHODS: The ITA pedicled grafts were sprayed and wrapped in sponges soaked in dilute papaverine solution in 14 patients and prepared with intraluminal papaverine injection in 18 patients. For 23 other patients, the ITA was skeletonized. We measured the first free flow from the distal ITA early after the start of cardiopulmonary bypass and the second free flow just before the ITA was grafted to the left anterior descending artery. RESULTS: The first flow was greater in the skeletonized ITAs than in the ITA pedicled grafts with topical application of papaverine alone (38.9 +/- 15.8 versus 18.0 +/- 6.8 mL/min; p < 0.001). For the second flow, the pedicle grafts with intraluminal papaverine injection and the skeletonized ITAs showed greater flow rate than the pedicled grafts with topical application of papaverine (67.4 +/- 25.5 and 59.7 +/- 22.5 versus 38.1 +/- 13.1 mL/min; p < 0.005 and p < 0.05, respectively), but there was no significant difference between the former two groups (p = 0.53). CONCLUSIONS: Skeletonization of the ITA is as efficient a strategy to increase the flow as intraluminal papaverine injection for the ITA pedicled graft. When the ITA is harvested in a skeletonized fashion, arterial spasm and reduced early flow can be avoided, even without intraluminal injection of papaverine.
Authors:
J B Choi; S Y Lee
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  61     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1996 Mar 
Date Detail:
Created Date:  1996-06-12     Completed Date:  1996-06-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  909-13     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Wonkwang University School of Medicine, Iksan, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Humans
Male
Middle Aged
Myocardial Revascularization / methods*
Regional Blood Flow
Thoracic Arteries / physiology,  transplantation*
Comments/Corrections
Comment In:
Ann Thorac Surg. 1996 Oct;62(4):1248-9   [PMID:  8823140 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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