الفهرس 
AnatomyOnly 14 pages are availabe for public view
Abstract
T
his prospective randomized study was carried out over 3 years including 200 patients for whom CABG surgery was performed. We compared 2 properly matched groups (100 patients each):
Group (A): Included CABG patients with pedicled left internal mammary artery (LITA)
Group (B): Included CABG patients with skeletonized left internal mammary artery ((LITA)
Preoperative stage of preparation / assessment included standard steps in all patients which started by careful and thorough history taking and clinical examination taking into consideration the patient’s age, sex, risk factors, 12-lead resting ECG) routine investigations (Labs, Plain chest X-rays; echocardiographic examination, coronary angiography, Doppler study for the carotid arteries, and the radial artery, in addition to the modified Allen’s test.
Intraoperatively
Group (A) the internal mammary artery is harvested as pedicled graft while in group (B) the internal mammary artery is harvested as skeletonized graft.
The distal ends were done and the last one to be done is (LITA) anastomosis to LAD. The top ends were done on side bitter clamp
After coming off bypass flow assessment of the graft were done especially the flow inside the (LITA) using Doppler flow probe (VARIQ C).
The average of flow in group (A) was 74.6 ml/ min. with SD 6.2 while in group (B) was 80.5 with SD 4.4.
The number of grafts in group (A) was 3 grafts in 40 cases 2 grafts in 20 cases 1 graft in 10 cases and 5 grafts in 10 patients.
The number of grafts in group (B) was 3 grafts in 50 cases 2 grafts in 25 cases 1 graft in 7 cases and 5 grafts in 5 cases.
The average cross clamp time in group (A) was 40 minutes while in group (B) the average cross clamp time was 50 minutes.
The intra aortic balloon pump was used in 4 cases in group (A) while in 2 cases in group (B).
Post operatively
The average ICU stay was 2 days in group(A) while 1 day in group (B).
The post operative bleeding happened in 8 cases in group (A) while 5 cases in group (B).
Superficial wound infection occurred in 10 cases in group (A) while in 8 cases in group (B)
The deep wound infection (mediastinitis) occurred in just one case from group (A) and one case from group (B).