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.

Bilateral internal mammary artery grafting in obese: outcomes, concerns and controversies / Vitulli, P; Frati, Giacomo; Benedetto, U.. - In: INTERNATIONAL JOURNAL OF SURGERY. - ISSN 1743-9191. - ELETTRONICO. - (2015), pp. 158-162. [10.1016/j.ijsu.2015.01.010]

Bilateral internal mammary artery grafting in obese: outcomes, concerns and controversies.

FRATI, GIACOMO;
2015

Abstract

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.
2015
Bilateral internal mammary artery grafting, Coronary artery bypass graft, Coronary heart disease, Obesity
01 Pubblicazione su rivista::01a Articolo in rivista
Bilateral internal mammary artery grafting in obese: outcomes, concerns and controversies / Vitulli, P; Frati, Giacomo; Benedetto, U.. - In: INTERNATIONAL JOURNAL OF SURGERY. - ISSN 1743-9191. - ELETTRONICO. - (2015), pp. 158-162. [10.1016/j.ijsu.2015.01.010]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/780522
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