title: Off-pump Skeletonized Versus Pedicled Left Internal Mammary Artery Grafting: Mid-term Results.
abstract: BACKGROUND
  Skeletonization of the internal mammary artery for single left internal mammary artery (LIMA) use remains controversial. We sought to elucidate the effect of different harvesting techniques applied in single LIMA grafting.
  
  
  METHODS
  Between January 2006 and January 2012, 982 patients undergoing off-pump coronary artery bypass with pedicled LIMA conduits (P Group) and 928 patients undergoing the same operation with skeletonized LIMA conduits (S Group) were enrolled. The length and blood flow of the conduits, and in-hospital and mid-term outcomes with one-year postoperative graft angiographic results were analyzed and compared between groups.
  
  
  RESULTS
  Twenty-five (2.7%) patients in the S group died in hospital, compared with 26 (2.6%) in the P group, with similar rates of sternal wound infection, chest wall pain, and low-output syndrome. Although the length and blood flow of conduits were increased in the S Group, postoperative conduit patency was similar between groups (p = 0.470). During a median follow-up of 32.2 months, the groups showed similar total survival (88.3 ± 3.2%, S Group; 85.5 ± 2.0%, P Group; p = 0.118) and cardiac event-free survival (82.7 ± 3.3%, S Group; 80.3 ± 2.0%; P Group; p = 0.129), with similar postoperative complications.
  
  
  CONCLUSIONS
  Skeletonization of single LIMA has no extra benefit in early or mid-term outcomes, suggesting no advantage over the pedicled technique.
authors: Department of Cardiac Surgery, Zhongshan Hospital of Fudan University & Shanghai Institute of Cardiovascular Diseases, Shanghai, P. R. China.|Department of Cardiothoracic Surgery, Huashan Hospital of Fudan University, Shanghai, P. R. China.
authors: Xiaotian
authors: X
authors: Sun
authors: Department of Cardiac Surgery, Zhongshan Hospital of Fudan University & Shanghai Institute of Cardiovascular Diseases, Shanghai, P. R. China.|Department of Cardiothoracic Surgery, Huashan Hospital of Fudan University, Shanghai, P. R. China.
authors: Jiechun
authors: J
authors: Huang
authors: Department of Cardiac Surgery, Zhongshan Hospital of Fudan University & Shanghai Institute of Cardiovascular Diseases, Shanghai, P. R. China.
authors: Wenshuo
authors: W
authors: Wang
authors: Department of Cardiac Surgery, Zhongshan Hospital of Fudan University & Shanghai Institute of Cardiovascular Diseases, Shanghai, P. R. China.
authors: Shuyang
authors: S
authors: Lu
authors: Department of Cardiac Surgery, Zhongshan Hospital of Fudan University & Shanghai Institute of Cardiovascular Diseases, Shanghai, P. R. China.
authors: Kai
authors: K
authors: Zhu
authors: Department of Cardiac Surgery, Zhongshan Hospital of Fudan University & Shanghai Institute of Cardiovascular Diseases, Shanghai, P. R. China.
authors: Jun
authors: J
authors: Li
authors: Department of Cardiac Surgery, Zhongshan Hospital of Fudan University & Shanghai Institute of Cardiovascular Diseases, Shanghai, P. R. China.
authors: Hao
authors: H
authors: Lai
authors: Department of Cardiac Surgery, Zhongshan Hospital of Fudan University & Shanghai Institute of Cardiovascular Diseases, Shanghai, P. R. China.
authors: Changfa
authors: C
authors: Guo
authors: Department of Cardiac Surgery, Zhongshan Hospital of Fudan University & Shanghai Institute of Cardiovascular Diseases, Shanghai, P. R. China.
authors: Chunsheng
authors: C
authors: Wang
mesh_terms: D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D008875:Middle Aged; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome; D014654:Vascular Patency