Does Bilateral Pedicle Internal Thoracic Artery Harvest Increase the Risk of Mediastinitis?
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Bilateral in situ internal thoracic artery (ITA) bypassing may result in excellent myocardial revascularization without increasing the risk of deep sternal wound infection. Although there have been concerns with the use of pedicled bilateral ITA, the risk of infection may not be greater than the use of skeletonized ITA. Materials and Methods: The present study was retrospectively undertaken to determine if pedicled BITA grafts are associated with a higher risk of sternal wound complications. A total of 207 patients who underwent bilateral ITA bypasses with or without existing diabetes mellitus, and 162 patients of those received bilateral pedicled ITA and 98 patients received unilateral ITA bypass grafts. Results: No sternal wound complications were noted in either the bilateral ITA or unilateral left ITA groups. Conclusion: Bilateral pedicled ITA harvesting was not associated with a greater incidence of infectious sternal complications compared to patients receiving unilateral ITA bypass grafts.
Abstract
Purpose: Bilateral in situ internal thoracic artery (ITA) bypassing may result in excellent myocardial revascularization without increasing the risk of deep sternal wound infection. Although there have been concerns with the use of pedicled bilateral ITA, the risk of infection may not be greater than the use of skeletonized ITA. Materials and Methods: The present study was retrospectively undertaken to determine if pedicled BITA grafts are associated with a higher risk of sternal wound complications. A total of 207 patients who underwent bilateral ITA bypasses with or without existing diabetes mellitus, and 162 patients of those received bilateral pedicled ITA and 98 patients received unilateral ITA bypass grafts. Results: No sternal wound complications were noted in either the bilateral ITA or unilateral left ITA groups. Conclusion: Bilateral pedicled ITA harvesting was not associated with a greater incidence of infectious sternal complications compared to patients receiving unilateral ITA bypass grafts.
참고문헌 (24)
- Lytle BW, "Superiority of bilateral internal thoracic artery grafting: it's been a long time comin’", Circulation, 104, pp.2152~2154 (2001)
- Buxton BF, "Bilateral internal thoracic artery grafting may improve outcome of coronary artery surgery. Risk-adjusted survival", Circulation, 98(19), pp.II1~II6 (1998)
- De Paulis R, "The effect of bilateral internal thoracic artery harvesting on superficial and deep sternal infection: The role of skeletonization", J Thorac Cardiovasc Surg, 129, pp.536~543 (2005)
- Borger MA, "Deep sternal wound infection: risk factors and outcomes", Ann Thorac Surg, 65, pp.1050~1056 (1998)
- Fiore AC, "Fifteen-year followup for double internal thoracic artery grafts", Eur J Cardiothoracic Surg, 5, pp.248~252 (1991)
- Peterson MD, "Skeletonization of bilateral internal thoracic artery grafts lowers the risk of sternal infection in patients with diabetes", J Thorac Cardiovasc Surg, 126, pp.1314~1319 (2003)
- Dion R, "Bilateral mammary grafting. Clinical, functional and angiographic assessment in 400 consecutive patients", Eur J Cardiothorac Surg, 7, pp.287~293 (1993)
- Tector AJ, "Total revascularization with T grafts", Ann Thorac Surg, 57, pp.33~38 (1994)
- Berreklouw E, "Better ischemic eventfree survival after two internal thoracic artery grafts: 13 years of follow-up", Ann Thorac Surg, 72, pp.1535~1541 (2001)
- Schmidt SE, "Improved survival with multiple left-sided bilateral internal thoracic artery grafts", Ann Thorac Surg, 64, pp.9~14 (1997)
- Burfeind WR Jr, "Single versus multiple internal mammary artery grafting for coronary artery bypass: 15-year follow-up of a clinical practice trial", Circulation, 110(11), pp.II27~II35 (2004)
- Hirotani T, "Feasibility and suitability of the routine use of bilateral internal thoracic arteries", Ann Thorac Surg, 73, pp.511~515 (2002)
- Gansera B, "Internal thoracic artery vs. vein grafts-postoperative angiographic findings in symptomatic patients after 1000 days", Thorac Cardiovasc Surg, 51, pp.239~243 (2003)
- Dion R, "Long-term clinical and angiographic follow up of sequential internal thoracic artery grafting", Eur J Cardiothorac Surg, 17, pp.407~414 (2000)
- Tavilla G, "Long-term follow-up of coronary artery bypass grafting in three-vessel disease using exclusively pedicled bilateral internal thoracic and right gastroepiploic arteries", Ann Thorac Surg, 77, pp.794~799 (2004)
- Mert M, "Mid-to-longterm patency comparison of the right internal thoracic artery grafts on the left anterior descending and on the right coronary arteries", Thorac Cardiovasc Surg, 51, pp.180~184 (2003)
- Endo M, "Benefit of bilateral over single internal mammary artery grafts for multiple coronary artery bypass grafting", Circulation, 104, pp.2164~2170 (2001)
- Stevens LM, "Single versus bilateral internal thoracic artery grafts with concomitant saphenous vein grafts for multivessel coronary artery bypass grafting: effects on mortality and event-free survival", J Thorac Cardiovasc Surg, 127, pp.1408~1415 (2004)
- Gansera B, "Does bilateral ITA grafting increase perioperative complications? Outcome of 4462 patients with bilateral versus 4204 patients with single ITA bypass", Eur J Cardiothorac Surg, 30, pp.318~323 (2006)
- Seyfer AE, "Sternal blood flow after median sternotomy and mobilization of the internal mammary arteries", Surgery, 104, pp.899~904 (1988)
- "Risk factors for deep sternal wound infection after sternotomy: a prospective, multicenter study", J Thorac Cardiovasc Surg, 111, pp.1200~1207 (1996)
- Athanasiou T, "Should the internal thoracic artery be skeletonized?", Ann Thorac Surg, 77, pp.2238~2246 (2004)
- Henriquez-Pino JA, "Surgical anatomy of the internal thoracic artery", Ann Thorac Surg, 64, pp.1041~1045 (1997)
- Ura M, "Bilateral pedicled internal thoracic artery grafting", Eur J Cardiothorac Surg, 21, pp.1015~1019 (2002)