PDF(Pubmed)
Abstract：
OBJECTIVE: It is uncertain whether Thunderbeat has a place in harvesting the left internal mammary artery (LIMA) and whether skeletonization is superior to pedicle-harvested LIMA. Some investigations have shown improved flowrates in the skeletonized graft. The aim of this study was to compare 3 groups of harvesting techniques: Pedicled, surgical skeletonized and skeletonized with Thunderbeat in terms of flow rates in the LIMA and postoperative in-hospital outcomes.
METHODS: Patients undergoing coronary artery bypass grafting with the LIMA to the anterior descending artery were randomized to pedicled (n = 56), surgical skeletonized (n = 55) and skeletonized with Thunderbeat (n = 54). Main outcomes were blood flow and pulsatility index in the graft.
RESULTS: No statistical difference between groups regarding flow in LIMA or pulsatility index. Similarly, no difference in postoperative bleeding or days of hospitalization. The duration of harvesting was faster for the pedicled technique compared with surgical skeletonized and skeletonized with Thunderbeat [mean total min: pedicled 20.2 min standard deviation (SD) ± 5.4; surgical skeletonized 28.6 min SD ± 8.7; skeletonized with Thunderbeat 28.3 min SD ± 9.11, P < 0.001]. No grafts discarded due to faulty harvesting and there was no graft failure within hospital stay.
CONCLUSIONS: We found no difference between the harvesting methods except for a significantly faster harvesting time with the pedicled technique. However, non-touch skeletonized LIMA harvesting with Thunderbeat seems to be an effective alternative to traditional surgical skeletonized LIMA. The future will reveal whether patency is harvesting dependent.
BACKGROUND: ClinicalTrials.gov Identifier: NCT05562908.
METHODS: Patients undergoing coronary artery bypass grafting with the LIMA to the anterior descending artery were randomized to pedicled (n = 56), surgical skeletonized (n = 55) and skeletonized with Thunderbeat (n = 54). Main outcomes were blood flow and pulsatility index in the graft.
RESULTS: No statistical difference between groups regarding flow in LIMA or pulsatility index. Similarly, no difference in postoperative bleeding or days of hospitalization. The duration of harvesting was faster for the pedicled technique compared with surgical skeletonized and skeletonized with Thunderbeat [mean total min: pedicled 20.2 min standard deviation (SD) ± 5.4; surgical skeletonized 28.6 min SD ± 8.7; skeletonized with Thunderbeat 28.3 min SD ± 9.11, P < 0.001]. No grafts discarded due to faulty harvesting and there was no graft failure within hospital stay.
CONCLUSIONS: We found no difference between the harvesting methods except for a significantly faster harvesting time with the pedicled technique. However, non-touch skeletonized LIMA harvesting with Thunderbeat seems to be an effective alternative to traditional surgical skeletonized LIMA. The future will reveal whether patency is harvesting dependent.
BACKGROUND: ClinicalTrials.gov Identifier: NCT05562908.
摘要：
目的：不确定Thunderbeat在左乳内动脉采集中是否有位置，以及骨骼化是否优于椎弓根采集的LIMA。一些研究表明，骨骼化移植物的流速有所提高。这项研究的目的是比较三组收获技术：带蒂，手术骨骼化和Thunderbeat骨骼化在左乳内动脉的流速和术后院内结局方面。
方法：将左乳内动脉与前降支进行冠状动脉旁路移植术的患者随机分为带蒂（n=56），手术骨骼化（n=55），用雷声（n=54）骨架化。主要结果是移植物中的血流和搏动指数。
结果：在LIMA流量或搏动指数方面，组间无统计学差异。同样，术后出血或住院天数无差异.与手术骨骼化和Thunderbeat骨骼化相比，带蒂技术的收获持续时间更快（平均总min：带蒂20.2minSD±5.4；手术骨骼化28.6minSD±8.7；Thunderbeat骨骼化28.3minSD±9.11，p<0.001）。没有由于错误的收获而丢弃的移植物，并且在住院期间没有移植物失败。
结论：我们发现除了带蒂技术的收获时间明显加快之外，收获方法之间没有差异。然而,用Thunderbeat进行非接触式骨骼化左乳内动脉采集似乎是传统手术骨骼化LIMA的有效替代方法。未来将揭示开放是否依赖于收获。
方法：将左乳内动脉与前降支进行冠状动脉旁路移植术的患者随机分为带蒂（n=56），手术骨骼化（n=55），用雷声（n=54）骨架化。主要结果是移植物中的血流和搏动指数。
结果：在LIMA流量或搏动指数方面，组间无统计学差异。同样，术后出血或住院天数无差异.与手术骨骼化和Thunderbeat骨骼化相比，带蒂技术的收获持续时间更快（平均总min：带蒂20.2minSD±5.4；手术骨骼化28.6minSD±8.7；Thunderbeat骨骼化28.3minSD±9.11，p<0.001）。没有由于错误的收获而丢弃的移植物，并且在住院期间没有移植物失败。
结论：我们发现除了带蒂技术的收获时间明显加快之外，收获方法之间没有差异。然而,用Thunderbeat进行非接触式骨骼化左乳内动脉采集似乎是传统手术骨骼化LIMA的有效替代方法。未来将揭示开放是否依赖于收获。
