title: Two questions on bilateral internal mammary artery usage.
abstract: The use of a single internal mammary graft to the left anterior descending artery has been the gold standard in surgical coronary revascularization since its introduction. However, the take-up rate of use of bilateral internal mammary arteries has been slow despite emerging evidence. This has been partly due to the worry of postoperative complications, in particular, sternal wound complications. Skeletonization of the internal mammary has been proposed as a technique that can preserve the sternal microcirculation and therefore reduce this complication. In this article, we examine the evidence comparing the skeletonization technique versus the conventional pedicled technique for harvesting the internal mammary artery.
authors.affiliation: Department of Cardiac Surgery, Royal Victoria Hospital, Belfast, UK.
authors.forename: Haralabos
authors.initials: H
authors.lastname: Parissis
authors.forename: Zeb
authors.initials: Z
authors.lastname: Chughtai
authors.forename: Alan
authors.initials: A
authors.lastname: Soo
mesh_terms: D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008323:Mammary Arteries / Q000503:physiopathology / Q000601:surgery*; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014654:Vascular Patency; D014945:Wound Healing
keywords: Cardiovascular surgical procedures; coronary artery bypass; internal mammary arteries; sternum; surgical wound dehiscence