scholarly journals Should We Do Bilateral Internal Mammary Artery Grafting in Diabetic Patients?

2020 ◽  
Author(s):  
Hassane Abdallah ◽  
Ahmed Ibrahim ◽  
Khalid Al Khamees
Keyword(s):  
Internal Mammary Artery ◽  
Diabetic Patients ◽  
Internal Mammary

scholarly journals Sternal healing after bilateral internal mammary arteries use for Coronary artery bypass grafting in diabetic Patients; short-term results

2020 ◽  
Author(s):  
Islam Moheb Ibrahim ◽  
Ahmed Labib Dokhan ◽  
Yahia Balbaa Anwar Balbaa ◽  
Ibrahim Mohammed Khalil ◽  
Mohammed Ahmed El-Hag-Aly
Keyword(s):  
Wound Infection ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Diabetic Patients ◽  
Bypass Grafting ◽  
Risk Of Infection ◽  
Mammary Arteries ◽  
Internal Mammary ◽  
Group A ◽  
Group B

Background:  Bilateral internal mammary artery (BIMA) use may improve long-term outcomes after coronary artery bypass grafting (CABG); however, the risk of infection is high.   Skeletonization of the internal mammary may decrease the risk of infection, especially in patients with diabetes. Our study aimed at evaluation of sternal healing in diabetic patients with different techniques of bilateral internal mammary artery harvesting. Methods: This prospective randomized study included 200 diabetic patients who underwent CABG using BIMA between 2017 and 2019. We divided patients into two groups; Group A had skeletonization of both internal mammary arteries, and Group B had pedicled left mammary and skeletonized right mammary. Patients were observed for three months, post-operatively for any sternal wound problems. Results: There was no significant difference regarding the baseline variables. Type I diabetes mellitus was present in 25% in group A (n= 24) and 13.64% in group B (n= 12) (p= 0.324). There was no difference in harvest time between groups (83 ±4 vs. 81 ±3 minutes in group A vs. B, respectively. P= 0.1). The mean number of grafts was 3± 0.5 in Group A and 3± 0.6 in Group B (p= 0.8). Postoperative drainage was 402.9 ± 174.1 ml in Group A vs. 387.2 ± 153.6 ml in Group B (p= 0.474). The duration of ICU stay did not differ significantly between groups (2± 0.7 in Group A vs. 2± 0.5 in Group B; p= 0.8). Deep sternal wound infection occurred in 4.17% in group A (n= 4) and 4.55% in group B (n= 4) (p= 0.705). Superficial wound infection occurred in eight patients in group A (8.33%) and eight patients in group B (9.1%) (p= 0.59). No patient had sternal dehiscence in group A vs. four patients in group B (4.55%) (p= 0.39). Conclusion: We did not find differences between bilateral mammary artery harvest with skeletonization of both arteries versus skeletonization of the right mammary only on sternal healing nor wound infection in diabetic patients undergoing CABG. A larger study is recommended.

scholarly journals Role of Gender, Smoking Profile, Hypertension, and Diabetes on Saphenous Vein and Internal Mammary Artery Endothelial Relaxation in Patients with Coronary Artery Bypass Grafting

2010 ◽  
Vol 3 (3) ◽  
pp. 199-205 ◽  
Author(s):  
Andrew Duncan Muir ◽  
Pascal Patrick McKeown ◽  
Ulvi Bayraktutan
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Diabetic Patients ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Internal Mammary

The aim of this study was to investigate if there was a link between the relaxant responses in saphenous vein (SV) and internal mammary artery (IMA) segments obtained from patients undergoing coronary artery bypass grafting and the patients' cardiovascular risk factors. Endothelium-(in)dependent relaxations were assessed by isometric tension studies. Endothelium-dependent relaxant responses were greater in IMA than SV and gender, smoking profile and history of hypertension but not diabetes appeared to have an influence on these responses. Endothelium-dependent relaxant responses in both IMA and SV were greater in males than females and relaxant responses in IMA segments were attenuated in smokers, whereas the opposite effect was noted in SV segments. Endothelium-dependent relaxant responses in SV were lower in patients with hypertension. Endothelium-independent relaxant responses were greater in IMA than SV. Endothelium-independent responses were greater in male patients' SV segments, but gender played no role in IMA segments. Diabetes had no effect on endothelium-independent responses in IMA, but SV segments from diabetic patients had greater responses. Neither conduit's endothelium-independent response was affected by hypertensive status. The relationship between risk factor status and endothelial responses is multifactorial, with gender, hypertension, diabetes and smoking status all contributing.

scholarly journals Bilateral Internal Mammary Artery Grafting Enhances Survival in Diabetic Patients

Circulation ◽  
2012 ◽  
Vol 126 (25) ◽  
pp. 2935-2942 ◽  
Author(s):  
Malcolm J. Dorman ◽  
Paul A. Kurlansky ◽  
Ernest A. Traad ◽  
David L. Galbut ◽  
Melinda Zucker ◽  
...  
Keyword(s):  
Internal Mammary Artery ◽  
Diabetic Patients ◽  
Internal Mammary

scholarly journals Bilateral Internal Mammary Artery Use in Diabetic Patients: Friend or Foe?

2018 ◽  
Vol 106 (4) ◽  
pp. 1088-1094 ◽  
Author(s):  
Todd C. Crawford ◽  
Xun Zhou ◽  
Charles D. Fraser ◽  
J. Trent Magruder ◽  
Alejandro Suarez-Pierre ◽  
...  
Keyword(s):  
Internal Mammary Artery ◽  
Diabetic Patients ◽  
Internal Mammary

scholarly journals Risk Factors and Treatment for Mediastinitis in Internal Mammary Artery Grafting, with Particular Regard to Diabetic Patients.

2000 ◽  
Vol 29 (1) ◽  
pp. 5-9
Author(s):  
Zenichi Masuda ◽  
Takato Hata ◽  
Yoshimasa Tsushima ◽  
Mitsuaki Matsumoto ◽  
Souhei Hamanaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Internal Mammary Artery ◽  
Diabetic Patients ◽  
Internal Mammary
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