Incidence of Sternal Infection in Diabetic Patients Undergoing Bilateral Internal Thoracic Artery Grafting
Open accessAbstract
Background Bilateral internal thoracic artery (BITA) bypass grafts have advantages over single internal thoracic artery (SITA) bypass grafts in the medium term, particularly in diabetics. However, the perceived higher sternal complication rates seen in diabetics have led many surgeons to avoid the use of BITA surgery. The aim of our study was to assess the validity of this approach by assessing the incidence of sternal infections over a 10-year period in one institution.Methods A retrospective analysis was made of our coronary artery bypass graft (CABG) patients over a 10-year period (7,581 patients). Nine hundred and twenty-two of the patients were diabetics (261 insulin-dependent diabetes mellitus [IDDM]). Of the insulin-dependent diabetics, 166 had SITA, and 95 had BITA grafts.Results There was no significant difference in this subgroup in terms of gender, preoperative angina, dyspnea class, left ventricular function, and number of distal anastomoses. Comparing the rates of sternal wound complications of SITA and BITA in IDDM are the following: (1) superficial sternal infection, 6.6% in SITA, 1.1% in BITA (p = 0.04); (2) deep sternal infection, 1.2% in SITA, 3.2% in BITA (p = 0.27); (3) sternal dehiscence, 1.2% in SITA, 3.2% in BITA (p = 0.27).Conclusions Our data do not support the perception that BITA grafting increases the risk of sternal complications in insulin-dependent diabetic patients.
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Bilateral internal mammary artery grafting is used less often than single internal mammary artery grafting because of concerns about higher sternal wound infection rates.
“Bilateral IMA implantation is less commonly used than single IMA implantation because of concern about increased sternal wound infection rates.282–284”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [283]
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- Authors
- Momin, A. U., Deshpande, R., Potts, J., El-Gamel, A., Marrinan, M. T., Omigie, J., & Desai, J. B.
- Affiliations
- King's College Hospital (GB)
- Venue
- The Annals of Thoracic Surgery
- Publisher
- Elsevier BV
- Published
- 2005-11
- Volume
- 80
- Issue
- 5
- Pages
- 1765-1772
- ISSN
- 0003-4975 (ISSN-L)
- OpenAlex
- W2118951651
- Cited by
- 60
- References
- 25
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 6 · 2022: 1 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 6 · 2014: 4 · 2013: 6 · 2012: 7
- FWCI
- 3.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Annals of Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Health Sciences › Medicine › Surgery › Surgical site infection prevention
- Health Sciences › Medicine › Surgery › Infectious Aortic and Vascular Conditions
- Keywords
- sternal wound infection, bilateral internal thoracic artery grafting, coronary artery bypass grafting, diabetes mellitus, type 1 diabetes, sternal wound complications, sternal dehiscence, deep sternal infection
- MeSH terms
- Aged, Female, Humans, Infections, Male, Mammary Arteries, Middle Aged, Postoperative Complications, Risk Factors, Sternum, Surgical Wound Infection, Incidence, Diabetes Complications
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