title: A Review of Differing Techniques of Mammary Artery Harvesting on Sternal Perfusion: Time for a Randomized Study?
abstract: The use of internal mammary artery (IMA) grafts for coronary artery bypass may devascularize the sternum. We performed a literature review by searching the PubMed database for studies that assessed sternal perfusion after IMA harvesting. The majority of papers describe various techniques and compared (1) IMA harvest versus no IMA harvest, (2) single versus bilateral, and (3) skeletonized versus pedicled. Evidence is inconclusive as to whether single harvesting causes significant devascularisation and whether this is increased with bilateral harvesting. Sternal ischemia may also be a transient phenomenon. However, skeletonization may preserve perfusion more than pedicled harvesting, particularly in diabetic patients.
authors.affiliation: Medical Sciences Division, University of Oxford, Oxford, United Kingdom.
authors.forename: Kevin
authors.initials: K
authors.lastname: Cheng
authors.affiliation: Department of Cardiothoracic Surgery, Oxford University Hospitals NHS Trust, Oxford, United Kingdom. Electronic address: mobyrehman@gmail.com.
authors.forename: Syed M
authors.initials: SM
authors.lastname: Rehman
authors.affiliation: Department of Cardiothoracic Surgery, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
authors.forename: David P
authors.initials: DP
authors.lastname: Taggart
mesh_terms: D003324:Coronary Artery Disease / Q000601:surgery; D003925:Diabetic Angiopathies / Q000601:surgery; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D007511:Ischemia / Q000517:prevention & control; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic; D013249:Sternum / Q000098:blood supply*; D020858:Tissue and Organ Harvesting / Q000379:methods*