Effects of ultrasonic skeletonization on internal thoracic and gastroepiploic arteries for coronary artery bypass grafting

Eur J Cardiothorac Surg. 2006 Oct;30(4):592-6. doi: 10.1016/j.ejcts.2006.07.024. Epub 2006 Aug 28.

Abstract

Objective: There are few data available on the effect of ultrasonic skeletonization with the harmonic scalpel on internal thoracic artery (ITA) and gastroepiploic artery (GEA) vessel function.

Methods: Rings of segments of the skeletonized ITA, pedicled ITA, skeletonized GEA, and pedicled GEA were studied. Arterial segments were treated with high KCl and norepinephrine (NE) to obtain smooth muscle contractions. Endothelium-dependent and independent vasorelaxant potencies in 10(-6)mol/l NE-pre-constricted arteries were assessed by acetylcholine (ACh), and isosorbide dinitrate (ISDN) and diltiazem, respectively.

Results: There were no differences in contractile potencies induced by high KCl and NE between the rings cut from skeletonized and pedicled grafts. The rings from skeletonized and pedicled vessels also showed equal sensitivity to ISDN and diltiazem. However, the rings from pedicled grafts showed greater relaxation responses to ACh than rings from skeletonized grafts.

Conclusion: Ultrasonic complete skeletonization with the harmonic scalpel may retain smooth muscle function of skeletonized grafts, whereas endothelial function of ultrasonic skeletonized grafts may be significantly compromised.

Publication types

  • Comparative Study

MeSH terms

  • Acetylcholine
  • Analysis of Variance
  • Coronary Artery Bypass*
  • Coronary Disease / surgery*
  • Diltiazem
  • Endothelium, Vascular / diagnostic imaging
  • Endothelium, Vascular / physiopathology
  • Gastroepiploic Artery / diagnostic imaging*
  • Gastroepiploic Artery / physiopathology
  • Humans
  • Isosorbide Dinitrate
  • Mammary Arteries / diagnostic imaging*
  • Mammary Arteries / physiopathology
  • Muscle, Smooth, Vascular / diagnostic imaging
  • Muscle, Smooth, Vascular / physiopathology
  • Tissue and Organ Harvesting / instrumentation
  • Tissue and Organ Harvesting / methods*
  • Transplants
  • Ultrasonography
  • Vascular Patency
  • Vasodilator Agents

Substances

  • Vasodilator Agents
  • Diltiazem
  • Isosorbide Dinitrate
  • Acetylcholine