Bilateral skeletonized internal thoracic artery grafts in patients with diabetes mellitus

Abstract

Bilateral skeletonized internal thoracic artery grafting is a good surgical revascularization option in diabetic patients. Operative mortality and prevalence of sternal infection are comparable with those of nondiabetic patients. However, the risk of sternal infection in obese diabetic women is high, and for them we advocate the use of a single artery instead of bilateral internal thoracic arteries.

Bilateral Versus Unilateral Internal Mammary Revascularization in Patients With Diabetes

“…The use of arterial grafts in coronary revascularization was not recommended for diabetic patients in previous reports, 3,4,30 because this method was thought to increase complications such as mediastinitis. We recommend skeletonizing the IMA graft, because we found that this method of dissecting IMA graft may lower the risk of complications.…”

Trends in postcoronary artery bypass graft sternal wound dehiscence in a provincial population

“…Matsa et al (26) and Lev-Ran et al (27) also showed an increased incidence of sternal wound dehiscence in patients who were obese, female and diabetic, and recommended avoidance of the use of bilateral internal thoracic artery in this specific population. Other work has shown obesity and diabetes to be risk factors for the development of sternal wound dehiscence (1,4,11,28,29).…”

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

“…MENEZES, AM ET AL -Technical aspects in skeletonization of the internal thoracic artery using an ultrasonic scalpel the morbimortality between the utilization of only one ITA or of both [19][20][21][22][23]. In our series, no cases of infections (osteomyelitis or mediastinitis) were observed even though electrocautery and bone wax were used for sternal hemostasis, when necessary.…”