Comparison of the Mammary Harvesting Technique

A total of 90 patients were examined in a prospective randomized study. In 60 patients referred for coronary artery bypass grafting (CABG), LIMA was harvested, one-half (n=30) skeletonized, and one-half (n=30) with a pedicle. Thirty patients operated via sternotomy without LIMA harvesting (other procedures, for instance, valve surgery) were the control group. In patients undergoing LIMA harvest, harvest duration, graft length, and graft free flow were measured at defined arterial pressure. In all patients, the sternal blood flow was examined by active dynamic thermography (DIRT): first preoperatively and on 4th postoperative day. During this, the time of spontaneous rewarming of the skin surface after the application of a cold stimulus was measured in the caudal part of the sternum. The difference between postoperative and preoperative time was calculated and compared between groups.

Inclusion criteria

• Elective cardiac surgery procedure via median sternotomy
• The left mammary artery (LIMA) harvesting for coronary bypass planned as a part of the operation - Group 1 and 2
• Other cardiac surgery procedures without the LIMA harvesting (valve surgery for instance) - Control group
• Signing of the informed consent

Exclusion criteria

• Emergent surgery
• Re-operation
• Re-sternotomy
• Thoracotomy approach
• Harvesting of both mammary arteries (BIMA)
• Endocarditis
• Ongoing non-cardiac infection
• Fever
• Circulatory failure
• Ongoing administration of catecholamines to patient
• Unsigned informed consent