Objective:To compare and analyze the application effect of obtaining skeletonized or pedicled internal mammary artery(IMA)in off-pump coronary artery bypass grafting(OPCABG).Methods:110 patients who underwent OPCABG were enrolled in the trialfrom October 2020 to April 2022.Of the 110 participated patients,81 were male,29 were female,with an average age of 58.6±8.7.Patients were divided into skeletonized group(n=54)and pedicled group(n=56)according to the intraoperative IMA acquisition.All patients were harvested LIMAs when they underwent OPCABG from median thoracic incision.LIMAs were anastomosised to the left anterior descending artery.The time of artery acquisition,hospital stay,postoperative flow,postoperative drainage,c-reactive protein(CRP),chest incision infection and sternum dehiscence were compared between the two groups.Results:The blood flow of internal mammary bridge in the skeletonized group was significantly higher than that in the pedicled group(73.56±40.16)mL/min vs.(58.26±33.27)mL/min,P＜0.05,and the IMA acquisition time in the skeletonized IMA group was significantly longer than that in the pedicled IMA group(31.6±7.8)min vs.(24.3±8.1)min,P＜0.05.The biood flow of IMA in the skeletonized group was better than that in the pedicled group(428.6±318.7)mL vs.(541.7±332.5)mL,P＜0.05).while the c-reactive protein,chest wound infection,sternum dehiscence and hospital stay were not statistically significant.In 15 months of follow-up after surgery.There was no significant difference in MACCE events,patency rate of internal mammary artery bridge and great saphenous vein bridge between the two groups.Conclusion:Compared with obtaining the pedicled internal mammary artery,it is more difficult to obtain the skeletonized IMA.In the skeletonized group,the blood flow of the IMA bridge is better,the skeletonized internal mammary artery bridge is longer,and the anterior descending branch of the lesion can be diffused in sequence,and the skeletonized IMA had less total drainage.The skeletonized IMA has a satisfactory effect in the early outcomes of OPCABG.
维普
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