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Internal Grant Competition DGC
START-UP grant

Comparison of influence of the mammary artery harvesting technique on perfusion of sternum using contactless dynamic thermography
Project IdSGS25/LF/2023
Main solverMUDr. Jiří Sieja
Period1/2023 - 12/2023
ProviderSpecifický VŠ výzkum
Anotation A. thoracica interna (a. mammaria interna, internal mammary artery, IMA) is the most frequently used vascular graft for surgical revascularization of the myocardium. Its superiority to other arterial and venous grafts as well as to PCI intervention in long-term patency and long-term mortality is proven. There are two basic techniques for its harvesting. A simpler and more frequently used method with harvesting together with accompanying veins, fascia and muscle called "pedicle" and a more difficult, time-consuming and less used method called "skeletonization technique": harvesting of the artery alone, without damaging of surrounding tissues. The used technique infulences the length of obtained vascular graft, its blood flow and long-term patency. Number of papers adresses these topics, recently favoring the skeletonization technique. The degree of damage of the vascular supply of the sternum and the subsequent healing conditions of the sternotomy also favor skeletonization harvesting. (less pain, less area of dysestesia, less risk of sternal wound infection) On the other hand, it is more time-consuming, surgically more difficult and has a long learning curve for surgeons. For that reasons, according to the valid guidelines for revascularisation the sceletonisation is currently recommended only in case of harvesting both mammary arteries and/or in diabetics. The aim of the sudy is to measure the difference in blood supply of the sternum after harvesting the left IMA using one or the second technique and to contribute to recommendation, whether the introduction of IMA skeletonization into the daily routine means profit for all patients - not only diabetics or patients with harvesting of both mammary arteries, or if only leads to more difficult and time-consuming operation.