Influence of different harvesting techniques on the arterial wall of the internal mammary artery graft: microscopic analysis. 1993

G Noera, and P Pensa, and R Lodi, and M Lamarra, and B Biagi, and P Guelfi
Department of Thoracic Surgery, University of Modena, Italy.

An histological comparison was made between left internal mammary arteries (LIMAs) harvested and prepared with different techniques prior to coronary artery bypass grafting. The mobilization of LIMA was made as follows: conventional technique (group I), extra pleural takedown with lysis of the endothoracic fascia (group II), and LIMA skeletonization (group III). Each group was divided into two other sub-groups according to the LIMA graft preparation: papaverine-saline solution sprayed on the pedicle (sub-group A) and intraluminal hydrostatic dilatation (sub-group B). Free blood flow from the LIMAs was measured immediately before cardiopulmonary bypass and ultrasonic duplex scanning (UDS) was performed to analyze the flow patterns and velocities during the early postoperative course. The results showed that the technique by which the LIMA is harvested bears no significant relationship to microscopical graft damage, while intimal lesions were observed in all sub-groups that adopted intraluminal hydrostatic dilatation (sub-group B). No difference in intraoperative LIMA flows were noted between groups and sub-groups of patients except in the case of group I-sub-group B, in which the flow was markedly reduced. Intramural haematoma or subadventitial blood effusion was observed with low incidence and magnitude in all groups and subgroups of patients, without any reduction of blood flow, and all LIMAs were patent at UDS measurements. In conclusion, the results showed that the method by which the IMA is harvested bears little and insignificant relationship to arterial wall damage.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007432 Intraoperative Period The period during a surgical operation. Intraoperative Periods,Period, Intraoperative,Periods, Intraoperative
D008297 Male Males
D008323 Mammary Arteries Arteries originating from the subclavian or axillary arteries and distributing to the anterior thoracic wall, mediastinal structures, diaphragm, pectoral muscles and mammary gland. Internal Mammary Artery,Internal Thoracic Artery,Arteries, Internal Mammary,Arteries, Internal Thoracic,Arteries, Mammary,Artery, Internal Mammary,Artery, Internal Thoracic,Artery, Mammary,Internal Mammary Arteries,Internal Thoracic Arteries,Mammary Arteries, Internal,Mammary Artery,Mammary Artery, Internal,Thoracic Arteries, Internal,Thoracic Artery, Internal
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009204 Myocardial Revascularization The restoration of blood supply to the myocardium. (From Dorland, 28th ed) Internal Mammary Artery Implantation,Myocardial Revascularizations,Revascularization, Myocardial,Revascularizations, Myocardial
D001783 Blood Flow Velocity A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D005260 Female Females
D006652 Histological Techniques Methods of preparing tissue for examination and study of the origin, structure, function, or pathology. Histologic Technic,Histologic Technics,Histologic Technique,Histologic Techniques,Histological Technics,Technic, Histologic,Technics, Histologic,Technique, Histologic,Techniques, Histologic,Histological Technic,Histological Technique,Technic, Histological,Technics, Histological,Technique, Histological,Techniques, Histological
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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