Clipless skeletonized internal mammary artery harvesting with harmonic technology

Zivojin S Jonjev 1Aleksandar M Milosavljevic 2Novica Kalinic 3Adam Adam 4

Affiliations

  • 1Institute for Cardiovascular Diseases of Vojvodina, Clinic of Cardiovascular Surgery, Sremska Kamenica, Serbia University of Banja Luka, Faculty of Medicine, Banja Luka, Republic of Srpska, Bosnia & Herzegovina.
  • 2Institute for Cardiovascular Diseases of Vojvodina, Clinic of Cardiovascular Surgery, Sremska Kamenica, Serbia.
  • 3University of Banja Luka, Faculty of Medicine, Banja Luka, Republic of Srpska, Bosnia & Herzegovina.
  • 4Icahn School of Medicine at Mount Sinai JJP VAMC, New York, NY, USA.

Free article

Abstract

Since the introduction of the mammary artery harvesting procedure, electrocautery has been used as a standard method of care. However, mammary artery spasm, subadventitial haematoma and mammary artery damage due to clips dispositioning or high thermal energy injury have been recorded. To achieve a perfect mammary artery graft, we propose the usage of a high-frequency ultrasound device, usually recognized as a harmonic scalpel. It reduces thermal-related injuries, the use of clips and the risk of mammary artery spasm and/or dissection.

Keywords: CABG; Conduit harvesting; Harvesting technique; IMA harvesting; Internal mammary artery.

© The Author 2023. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

https://mmcts.org/tutorial/1810

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