Effects of ultrasonic skeletonization on internal thoracic and gastroepiploic arteries for coronary artery bypass grafting.
OBJECTIVE
There are few data available on the effect of ultrasonic skeletonization with the harmonic scalpel on internal thoracic artery (ITA) and gastroepiploic artery (GEA) vessel function.


METHODS
Rings of segments of the skeletonized ITA, pedicled ITA, skeletonized GEA, and pedicled GEA were studied. Arterial segments were treated with high KCl and norepinephrine (NE) to obtain smooth muscle contractions. Endothelium-dependent and independent vasorelaxant potencies in 10(-6)mol/l NE-pre-constricted arteries were assessed by acetylcholine (ACh), and isosorbide dinitrate (ISDN) and diltiazem, respectively.


RESULTS
There were no differences in contractile potencies induced by high KCl and NE between the rings cut from skeletonized and pedicled grafts. The rings from skeletonized and pedicled vessels also showed equal sensitivity to ISDN and diltiazem. However, the rings from pedicled grafts showed greater relaxation responses to ACh than rings from skeletonized grafts.


CONCLUSIONS
Ultrasonic complete skeletonization with the harmonic scalpel may retain smooth muscle function of skeletonized grafts, whereas endothelial function of ultrasonic skeletonized grafts may be significantly compromised.
Matsumoto
Kazuhisa
K
Second Department of Surgery, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. kazuhisa@m3.kufm.kagoshima-u.ac.jp
Tsuneyoshi
Isao
I
Iguro
Yoshifumi
Y
Kinjo
Tamahiro
T
Yotsumoto
Goichi
G
Ueno
Masahiro
M
Kanmura
Yuichi
Y
Sakata
Ryuzo
R
D000109:Acetylcholine; D000704:Analysis of Variance; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D004110:Diltiazem; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D024405:Gastroepiploic Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007548:Isosorbide Dinitrate; D008323:Mammary Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D009131:Muscle, Smooth, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D020858:Tissue and Organ Harvesting / Q000295:instrumentation / Q000379:methods*; D019737:Transplants; D014463:Ultrasonography; D014654:Vascular Patency; D014665:Vasodilator Agents
D014665:Vasodilator Agents; D004110:Diltiazem; D007548:Isosorbide Dinitrate; D000109:Acetylcholine