Volume 7, Issue 6, December 2019, Page: 158-162
Bilateral Internal Thoracic Artery Bypass Grafting in a High Risk Population - A Four Year Experience with STS Database Derived Clinical Outcomes
John Jeffrey Tyner, Prebys Cardiovascular Institute, San Diego, USA
Kate Jensen, Prebys Cardiovascular Institute, San Diego, USA
Alexander Conkey Tyner, Applied Physics, Northwestern University, Evanston, USA
Ashley Jaravata, Clinical Care Lines, Scripps Hospital, San Diego, USA
Received: Jul. 14, 2019;       Accepted: Oct. 5, 2019;       Published: Oct. 24, 2019
DOI: 10.11648/j.js.20190706.12      View  62      Downloads  18
Abstract
The purpose of this retrospective review was to examine the morbidity and mortality associated with the routine use of skeletonized bilateral internal thoracic arteries (BITA) in coronary bypass surgery (CABG). The current rate of BITA use is reported to be 5% in the US. The literature reflects an increased incidence of wound complications, especially in obese, diabetic, and female patients. Our policy has been to use skeletonized BITA in patients regardless of comorbidities. Using the Society of Thoracic Surgery (STS) database, the postoperative markers of prolonged ventilation (PV), length of stay (LOS), wound infection, death, and 30 day readmission were evaluated for all isolated coronary bypass operations (isocab) to allow comparison of bilateral and single internal thoracic artery (ITA) use during this four year period. The incidence of BITA use was 60%. The groups had similar comorbities and postop complications were similar regardless of single or bilateral thoracic artery use. Specifically, there were no wound complications in the BITA group. Adjuncts such as ITA skeletonization, platelet rich plasma, negative pressure wound dressing, and absence of bone wax were utilized in all cases. The added expense is justified to allow the expanded use of BITA.
Keywords
Coronary Bypass, Skeletonized Internal Thoracic Arteries, Bilateral Internal Thoracic Arteries, Wound Complications, Platelet Rich Plasma, Negative Pressure Wound Dressing
To cite this article
John Jeffrey Tyner, Kate Jensen, Alexander Conkey Tyner, Ashley Jaravata, Bilateral Internal Thoracic Artery Bypass Grafting in a High Risk Population - A Four Year Experience with STS Database Derived Clinical Outcomes, Journal of Surgery. Vol. 7, No. 6, 2019, pp. 158-162. doi: 10.11648/j.js.20190706.12
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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