TY - JOUR
T1 - Bilateral internal mammary artery grafting in obese
T2 - Outcomes, concerns and controversies
AU - Vitulli, Piergiusto
AU - Frati, Giacomo
AU - Benedetto, Umberto
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Obese patients are generally considered unsuitable to receive bilateral internal mammary arteries (BIMA) during coronary artery bypass grafting (CABG) due to the perceived vulnerability to sternal wound infection and lack of evidence supporting long-term survival benefit. However, no consistent evidence currently discourages the use of BIMA in obese patients. The present review questions the common perception that obesity unacceptably increases the risk of sternal wound complications in patients receiving BIMA grafting. Moreover, the use of skeletonization harvesting technique is expected to further minimize such a risk. Our institutional experience confirmed that BIMA grafting is a safe strategy which does not increase operative mortality and does not significantly affect the incidence of sternal wound complications. On the other hand, a long term benefit in terms of overall survival and freedom from repeat revascularization from the use of BIMA was found.
AB - Obese patients are generally considered unsuitable to receive bilateral internal mammary arteries (BIMA) during coronary artery bypass grafting (CABG) due to the perceived vulnerability to sternal wound infection and lack of evidence supporting long-term survival benefit. However, no consistent evidence currently discourages the use of BIMA in obese patients. The present review questions the common perception that obesity unacceptably increases the risk of sternal wound complications in patients receiving BIMA grafting. Moreover, the use of skeletonization harvesting technique is expected to further minimize such a risk. Our institutional experience confirmed that BIMA grafting is a safe strategy which does not increase operative mortality and does not significantly affect the incidence of sternal wound complications. On the other hand, a long term benefit in terms of overall survival and freedom from repeat revascularization from the use of BIMA was found.
KW - Bilateral internal mammary artery grafting
KW - Coronary artery bypass graft
KW - Coronary heart disease
KW - Obesity
UR - http://www.scopus.com/inward/record.url?scp=84927796081&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84927796081&partnerID=8YFLogxK
U2 - 10.1016/j.ijsu.2015.01.010
DO - 10.1016/j.ijsu.2015.01.010
M3 - Article
C2 - 25598215
AN - SCOPUS:84927796081
VL - 16
SP - 158
EP - 162
JO - International Journal of Surgery
JF - International Journal of Surgery
SN - 1743-9191
IS - PB
ER -