Does the use of the skeletonized internal thoracic artery result in less postoperative bleeding than the pedicled internal thoracic artery in coronary artery bypass surgery?

Abstract

Objective: To compare the postoperative bleeding between the skeletonized grafts and pedicled internal thoracic artery (ITA) in coronary artery bypass.

Material and Method: 132 elective patients submitted to the surgery of myocardial revascularization were retrospectively analyzed and the sample was equally distributed in groups according to the dissection performed on the ITA: G1, skeletonized and G2, pedicled. In both methods, the dissection was finished before the heparinization and the installation of extracorporeal circulation. The following clinical parameters were evaluated: extracorporeal circulation time, aortic clamping, drainage debit and administration of hemocomponents (erythrocytes and platelets).

Results: The average number of platelets concentrations and the drainage debit on the postoperative period were statistically higher for the pedicled dissection of the ITA compared to the skeletonized one. No statistically significant differences were observed regarding the use of one or two mammary arteries, as well as for the time of extracorporeal circulation and anoxia in the studied groups.

Conclusion: The skeletonized preparation of the internal thoracic artery significantly reduced the blood loss after an elective surgery of myocardial revascularization.