title: Decreased sternal vascularity after internal thoracic artery harvesting resolves with time: an assessment with single photon emission computed tomography.
abstract: OBJECTIVE
  We sought to prospectively evaluate the long-term effect of left internal thoracic artery harvesting on sternal vascularity.
  
  
  METHODS
  Twelve consecutive patients undergoing primary coronary artery bypass grafting were studied. In all patients a pedicled left internal thoracic artery was harvested. Each patient underwent a preoperative technetium-99m methylene diphosphonate bone scan with single photon emission computed tomography. The ratio of the mean counts per pixel for each side of the sternum was obtained. All patients had early repeat bone scans 6 plus minus 2.4 days postoperatively and late repeat bone scans 18.6 plus minus 3.5 months after the operation. Ratios of unilateral sternal uptakes were compared between the different scans. One patient died during follow-up and was excluded from the study.
  
  
  RESULTS
  There was a significant decrease in flow to the left hemisternum in the early postoperative scan compared with that in the preoperative scan (P <.001). At late follow-up scans, flow to the left hemisternum had returned to normal (P =.119). Midterm clinical follow-up demonstrated 3 superficial wound infections. No musculoskeletal pain existed at the time of follow-up, but 3 patients had numbness or tingling at the skin area corresponding to the site from which the left internal thoracic artery was harvested.
  
  
  CONCLUSIONS
  Acute postoperative sternal ischemia caused by harvesting of a pedicled left internal thoracic artery is temporary and resolves with time.
authors.affiliation: Departments of Cardiovascular Surgery and Nuclear Medicine, The Edith Wolfson Medical Center, Holon, 58100 Israel. medalion@wolfson.health.gov.il
authors.forename: Benjamin
authors.initials: B
authors.lastname: Medalion
authors.forename: Michael G
authors.initials: MG
authors.lastname: Katz
authors.forename: Mordechai
authors.initials: M
authors.lastname: Lorberboym
authors.forename: Othman
authors.initials: O
authors.lastname: Bder
authors.forename: Arie
authors.initials: A
authors.lastname: Schachner
authors.forename: Amram J
authors.initials: AJ
authors.lastname: Cohen
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D013048:Specimen Handling / Q000009:adverse effects*; D013249:Sternum / Q000098:blood supply* / Q000000981:diagnostic imaging; D013669:Technetium Tc 99m Medronate; D013895:Thoracic Arteries / Q000637:transplantation*; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate