Impact of pleural integrity during mammary artery harvesting on short term outcome

Background

The aim of this retrospective study was to evaluate if the impact of pleural integrity during left internal mammary artery (LIMA) harvesting might influence short term outcome.

Methods

From May 2012 to May 2013, 136 patients undergoing isolated CABG operation (with or without pump) were enrolled in the study. The mammary artery was always harvested in a skeletonized fashion. These patients were split in two groups: Group A (96 pts) with open pleura and Group B (40 pts) with intact pleura. The two groups were comparable regarding pre- and operative data.

Results

There were no differences in mean values between Group A and Group B for: Age, BMI, LVEF, CPB time, Cross-clamp time, Number of anastomoses / patients. Group A and Group B were significantly different in terms of ventilation time ( 13,47+/-18,2 h vs 8,4+/-6,3h, p<0,001), bleeding within 12h (540,31+/-283,5 ml vs 392,25+/- 257,8ml, p<0,001), blood transfusion units (1,38+/-1,6 vs 0,6+/-1,4, p<0,001), and length of hospital stay ( 14,7+/-14,3 day vs 11,2+/-7, p<0,001).

Conclusions

Our data showed that preservation of pleura integrity, when possible, during LIMA harvesting has a strong impact on post-operative course. Pleural integrity can reduce postoperative bleeding with a minor need of blood transfusion. Very likely these finding along with a less time of ventilation might reduce the length of hospital stay.