Skeletonized Versus Pedicled Internal Mammary Harvest: Relationship of pain towards technique

Abstract

Objective: Purpose of this study is to compare skeletonized versus pedicled internal mammary harvest. Introduction: One of the commonly used procedures for multi-vessel and left main coronary artery disease is Coronary Artery Bypass Grafting (CABG with fewer and recurrent complication i.e. Post procedure pain that is an outcome of mechanical, thermal or ischemic injury to the inter-costal nerves during Internal Thoracic Artery (ITA) harvesting. Methodology: This study is being done to examine whether skeletonized or pedicle harvesting results in lesser occurrence and intensity of post-CABG pain with aim to identify which one is the better of the two techniques that can be used in future for patients planned with CABG. 63 consecutive patients were recruited at Tabba Heart Institute who underwent median sternotomy for CABG with Internal Thoracic Artery harvest were included. Group A went harvesting through skeletonization whereas patients in group B underwent harvesting by Pedicle ITA. This initial screening was done with the help of pre designed questionnaire. The data statistically analyzed by SPSS. Results: The results of study concluded that skeletonization of ITA does not reduce post coronary artery bypass graft surgery pain at the end of one month intervals. It is suggested that that skeletonized ITA is only beneficial when bilateral ITA are used. Conclusion: It was concluded that skeletonization of ITA does not reduce post coronary artery bypass graft surgery pain at the end of one month intervals. We suggest that that skeletonized ITA is only beneficial when bilateral ITA has been used.