Abdulkadir Bilgiç1, Emrah Uğuz2, Kemal Eşref Erdoğan2, Aydan Kılıçaslan4, Mecit Gökçimen3, Mete Hıdıroğlu2, Erol Şener2
1Department of Cardiovascular Surgery, Selahaddin Eyyübi State Hospital, Diyarbakır, Turkey
2Departments of Cardiovascular Surgery, 4Pathology, Atatürk Training and Research Hospital, Ankara, Turkey
3Department of Cardiovascular Surgery, Yozgat State Hospital, Yozgat, Turkey
Keywords: Coronary artery bypass surgery; electrocautery; graft harvesting; internal thoracic artery
Objectives: In this study, we aim to investigate whether internal thoracic artery harvesting with the PlasmaBlade™ is more effective and safer than electrocautery in preserving the integrity of the intima and pedicle of the internal thoracic artery.
Patients and methods: Between January 2014 and March 2014, a total of 40 patients were randomized to undergo internal thoracic artery harvesting with the PlasmaBlade™ (group 1; n=20) or electrocautery (group 2; n=20). Internal thoracic artery sections (intima and pedicle) were stained with hematoxylin-eosin, van Gieson's and Masson's trichrome stains. Their integrity was morphologically assessed using the light microscopy.
Results: Histological examination showed that endothelium was well preserved and endothelial injury scores were significantly lower in group 1, compared to group 2 (p=0.020). Bleeding scores for the vessel wall and the pedicle were also significantly lower in group 1, compared to group 2 (p=0.020). The mean injury zone width was significantly shorter in group 1 (0.335 mm and 0.730 mm in group 1 and 2, respectively) (p=0.000).
Conclusion: The PlasmaBlade™ is safer and more effective in preserving the integrity of the intima and pedicle of the internal thoracic artery than electrocautery for internal thoracic artery harvesting in coronary artery bypass grafting. A well-preserved endothelial function may provide higher graft patency rates.