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.
| Published in | Journal of Surgery (Volume 7, Issue 6) |
| DOI | 10.11648/j.js.20190706.12 |
| Page(s) | 158-162 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2019. Published by Science Publishing Group |
Coronary Bypass, Skeletonized Internal Thoracic Arteries, Bilateral Internal Thoracic Arteries, Wound Complications, Platelet Rich Plasma, Negative Pressure Wound Dressing
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APA Style
John Jeffrey Tyner, Kate Jensen, Alexander Conkey Tyner, Ashley Jaravata. (2019). Bilateral Internal Thoracic Artery Bypass Grafting in a High Risk Population - A Four Year Experience with STS Database Derived Clinical Outcomes. Journal of Surgery, 7(6), 158-162. https://doi.org/10.11648/j.js.20190706.12
ACS Style
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. J. Surg. 2019, 7(6), 158-162. doi: 10.11648/j.js.20190706.12
AMA Style
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. J Surg. 2019;7(6):158-162. doi: 10.11648/j.js.20190706.12
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Download@article{10.11648/j.js.20190706.12,
author = {John Jeffrey Tyner and Kate Jensen and Alexander Conkey Tyner and Ashley Jaravata},
title = {Bilateral Internal Thoracic Artery Bypass Grafting in a High Risk Population - A Four Year Experience with STS Database Derived Clinical Outcomes},
journal = {Journal of Surgery},
volume = {7},
number = {6},
pages = {158-162},
doi = {10.11648/j.js.20190706.12},
url = {https://doi.org/10.11648/j.js.20190706.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20190706.12},
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.},
year = {2019}
}
TY - JOUR T1 - Bilateral Internal Thoracic Artery Bypass Grafting in a High Risk Population - A Four Year Experience with STS Database Derived Clinical Outcomes AU - John Jeffrey Tyner AU - Kate Jensen AU - Alexander Conkey Tyner AU - Ashley Jaravata Y1 - 2019/10/24 PY - 2019 N1 - https://doi.org/10.11648/j.js.20190706.12 DO - 10.11648/j.js.20190706.12 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 158 EP - 162 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20190706.12 AB - 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. VL - 7 IS - 6 ER -
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