Routine use of bilateral skeletonized internal thoracic artery grafts in middle-aged diabetic patients.
BACKGROUND
The purpose of this study was to determine whether middle-aged diabetic patients aged less than 70 years could have routine use of bilateral skeletonized internal thoracic artery grafting without an increased surgical risk.


METHODS
Between January 1997 and December 2003, 712 consecutive patients aged less than 70 years underwent bilateral internal thoracic artery grafting. Among these, 164 were diabetic and underwent bilateral internal thoracic artery grafting without other preoperative selection than age. The postoperative results of these 164 nonselected consecutive diabetic patients were compared to these of the 548 nondiabetic patients.


RESULTS
The operative mortality rate was 4.3% (7 patients) in the diabetic group and 2.4% (13 patients) in the nondiabetic group (p = not significant [NS]). Deep sternal wound infection was observed in 2 patients (1.1%) in the diabetic group and in 6 patients (1.2%) in the nondiabetic group (p = NS). There were no significant difference in the morbidity rate between the two groups except for renal failure without dialysis (6.7% in the diabetic group vs 2.0% in the nondiabetic group, p < 0.01).


CONCLUSIONS
Routine use of bilateral internal thoracic artery grafting was performed in nonselected middle-aged diabetic patients without increased morbidity. The low rate of deep wound infections could be related to the skeletonized technique of internal thoracic artery harvesting.
Bical
Olivier M
OM
Department of Cardiac Surgery, Fondation Hopital Saint Joseph, Paris, France. ombical@hopital-saint-joseph.org
Khoury
Wassim
W
Fromes
Yves
Y
Fischer
Marc
M
Sousa Uva
Miguel
M
Boccara
Gilles
G
Deleuze
Philipe H
PH
D000368:Aged; D003327:Coronary Disease / Q000150:complications / Q000401:mortality / Q000601:surgery*; D048909:Diabetes Complications / Q000401:mortality*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D051437:Renal Insufficiency / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology