Kosmas I. Tsakiridis
St Luke’s Hospital, Greece
Title: BIMA Sceletonization. Tips, tricks and advantages
Biography
Biography: Kosmas I. Tsakiridis
Abstract
Introduction: The use of skeletonized bilateral mammary arteries (BIMA) in myocardial revascularization in off pump cardiac surgery has been established the last decades. Nevertheless, there is still a lot discussion and serious controversies about the broad aspect of this operation. Up to date there is no study that has examined the feasibility and the effect of the systematic use of skeletonized BIMA.
Methods: A short review of the literature helped us compare our result over the last ten years. This is a single center, retrospective observational study with 500 patients undergoing coronary artery bypass grafting. The vast majority of the operations were off the pump. BIMA was harvested skeletonized either with electrocautery or ultracision harmonic scalpel.
Results: There is an interesting rise in the percentages of BIMA through the years, reaching 80% of the patients in the last three years. The operations are almost exclusively off the pump. The graft flow was also measured with no significant differences between the arterial grafts. There were no major adverse cardiac events or complications, neither serious wound infections.
Conclusions: The systematic use of BIMA is safe and can be the gold standard for patients. The real discussion over this topic should include the coronary artery site selected for revascularization with the right mammary artery, regarding the length and the quality of the arterial graft. Furthermore, the surgical experience is an independent factor as well.