Aspectos técnicos na esqueletização da artéria torácica interna com bisturi ultra-sônico

Menezes, Alexandre; Vasconcelos, Frederico Pires; Lima, Ricardo de Carvalho; Costa, María A.; Escobar, Mozart

doi:10.1590/s0102-76382007000200009

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…Menezes et al [17] described the removal of the LITA using skeletonization employing an ultrasonic scalpel and without the use of metal clips. The results of 188 patients enrolled in this study were reported; there was no necessity to use maneuvers to increase the blood flow in the graft and there was no infection of the sternum.…”

Section: Discussionmentioning

confidence: 99%

Dupla artéria torácica esqueletizada versus convencional na revascularização do miocárdio sem CEC em diabéticos

Milani¹,

Brofman²,

Guimarães³

et al. 2008

Rev Bras Cir Cardiovasc

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Dupla artéria torácica esqueletizada versus convencional na revascularização do miocárdio sem CEC em diabéticosDouble skeletonized internal thoracic artery vs. double conventional internal thoracic artery in diabetic patients submitted to OPCAB Abstract Objective: To evaluate the influence of the technique used in the dissection of thoracic arteries in the evolution of diabetic patients submitted to OPCAB.Methods: Seventy diabetic patients submitted to OPCAB using bilateral thoracic arteries were evaluated. In Group A, thoracic arteries were dissected as a pedicle, while in Group B they were skeletonized.Results: The mean age of patients in Group A was 52.14 ± 7.35 years old versus 55.71 ± 8.1 years for Group B (p=0.057). In Group A, six patients (17.1%) were insulin dependent against nine (25.7%) in Group B (p = 0.561). The EUROSCORE was 3.97 ± 2.49 for Group A opposed to 4.14 ± 3.06 for Group B (p = 0.879). The number of distal anastomoses in Group A was 3 ± 0.77 versus 3.03 ± 0.89 in Group B (p = 0.981). Three patients (8.57%) from Group A presented with mediastinitis. Insulin dependence was the only significant risk factor (p=0.008) for mediastinitis. In this group the use of skeletonized ITAs significantly decreased the incidence of mediastinitis (p = 0.044).Conclusion: The incidence of mediastinitis was lower in the group for which thoracic arteries were dissected using skeletonization. Among insulin-dependent diabetics, 50% of the patients from the group in which the pedicled internal thoracic artery was utilized presented with mediastinitis; the utilization of skeletonized ITAs significantly decreases the incidence of mediastinitis. Rev Bras Cir Cardiovasc 2008; 23(3): 351-357 Descriptors

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Section: Discussionmentioning

confidence: 99%