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J Thorac Cardiovasc Surg 2003;125:638-641
© 2003 The American Association for Thoracic Surgery

Cardiopulmonary Support and Physiology

Early vasoreactive profile of skeletonized versus pedicled internal thoracic artery grafts

From the Departments of Cardiac Surgery^a and Cardiology,^b Catholic University, Rome, Italy.

Received for publication Oct 19, 2001. Revisions requested Dec 21, 2001; revisions received April 15, 2002. Accepted for publication May 21, 2002. Address for reprints: Mario Gaudino, MD, Divisione di Cardiochirurgia, Policlinico Universitario A. Gemelli, Largo A. Gemelli 8, 00168 Rome, Italy (E-mail: mgaudino{at}tiscalinet.it).

Background: No data are available on the early vasoreactive profile of skeletonized internal thoracic artery grafts.
Methods: Fifteen patients undergoing primary isolated coronary artery bypass grafting were randomly assigned to receive a skeletonized or pedicled internal thoracic artery graft. On the second postoperative day all patients were subjected to follow-up angiography and endovascular infusion of serotonin, acetylcholine, and isosorbide dinitrate.
Results: Internal thoracic artery grafts were widely patent in all cases. Mean diameters of the internal thoracic artery were 1.95 ± 0.17 mm in the pedicled group and 2.26 ± 0.40 mm in the skeletonized group. After serotonin challenge, mean internal thoracic artery diameters were reduced to 1.44 ± 0.34 mm and 1.64 ± 0.14 mm, respectively; acetylcholine challenge lead to a moderate degree of vasoconstriction (1.55 ± 0.59 mm in the pedicled group and 1.84 ± 0.15 mm in the skeletonized group). No statistically significant difference was evident between the two groups at any step.
Conclusion: Skeletonization does not affect the early vasoreactive profile of internal thoracic artery grafts used for surgical myocardial revascularization.

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