Off-pump Bilateral Internal Thoracic Artery Grafting

Background The long-term benefit of bilateral internal thoracic grafts (BITA) is well established. BITA grafting is often avoided in diabetic, female, obese, elderly and other high-risk patients because of concerns for deep sternal wound infection. The objective of this study is to analyse early res...

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Published in:Heart, lung & circulation lung & circulation, 2015-09, Vol.24 (9), p.905-911
Main Authors: Saha, Kamales Kumar, MCh, Deval, Mandar M., PDCC, Kumar, Ajay, MD, Kaushal, Ram P., MD, Saha, Kakalee K., MPhil, Jacob, Rinu V., BSc, Adsul, Ratnaprobha, BSc, Jagdale, Lukash, BSc
Format: Article
Language:English
Subjects:
Anaortic off-pump CABG
Bilateral internal thoracic artery grafting
CABG arterial graft
CABG new technology
Cardiovascular
Coronary artery bypass graft CABG
Coronary Artery Bypass, Off-Pump - adverse effects
Coronary Artery Bypass, Off-Pump - methods
Female
Humans
Male
Off-pump surgery
Retrospective Studies
Surgical Wound Infection - etiology
Surgical Wound Infection - prevention & control
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Summary:Background The long-term benefit of bilateral internal thoracic grafts (BITA) is well established. BITA grafting is often avoided in diabetic, female, obese, elderly and other high-risk patients because of concerns for deep sternal wound infection. The objective of this study is to analyse early results of our BITA grafting and to establish the safety of BITA use in all patients. Methods All cases of isolated consecutive unselected CABG were included in this retrospective study. BITA were used in-situ – one was used to graft left anterior descending artery and the other was used as inflow for a composite graft with radial artery. Dual inflow using in situ BITA grafting allows easy bailout by using an additional vein graft. Results BITA was used in 574 patients out of 602 (95.35%). Incidence of early death was 1.33% (8/602), stroke 0.5% (3/602), reoperation for bleeding 0.17% (1/602). Deep sternal wound infection was not seen in any patient but nine patients (1.5%) had superficial wound infection which healed with dressing. Conclusion We have used BITA in 95% of our unselected, consecutive off-pump CABG patients without any major wound complications. Our limited experience has shown off-pump CABG using BITA grafting can be safely adopted routinely with excellent early result.
ISSN:1443-9506
1444-2892
DOI:10.1016/j.hlc.2015.02.021