Early results of coronary grafting using ultrasonically skeletonized internal thoracic arteries

Background. We have developed an ultrasonic complete skeletonization techni que for obtaining internal thoracic artery (ITA) grafts and have used this method clinically since January 1998. In this report, we discuss the early results of bilateral ITA grafts obtained with our method. Methods. We studied 200 consecutive patients who underwent coronary artery bypass grafting using ITAs obtained by this technique. Angiography of the g rafts was performed in 188 patients (94%) within 1 month after coronary art ery bypass grafting. Results. The ITA grafts were about 4 cm longer than pedicled ITA grafts. Th e free flow through the grafts was at least 30% higher than through pedicle d ITAs. The early patency rate determined by postoperative angiography of t he grafts was 99.7% for left ITAs and 100% for right ITAs. No patient requi red postoperative intervention or repeated surgery. Conclusions. Ultrasonic complete skeletonization increases the effective le ngth of ITA bypasses, improves free now through the bypasses, and it is les s invasive than conventional pedicled harvesting. These excellent early res ults indicate that this technique is a straightforward, safe, less invasive , and optimal method for obtaining ITA bypass grafts. (C) 2001 by The Socie ty of Thoracic Surgeons.