Internal mammary harvesting causes pulmonary dysfunction – Myth versus fact

Abstract

ObjectivesThe lack of consistent data on the effect internal mammary harvesting on pulmonary functions has triggered the research group to answer the question using a prospective case control study. MethodsThis is a prospective study of 90 patients undergoing elective coronary artery bypass grafting operations (CABG), in the Cardiothoracic Surgery departments at Basildon University Hospitals, UK & Ain Shams University hospitals between September 2009 till November 2015 (51 & 39 patients respectively). The patients were divided into 3 groups based on the operative technique:Group I: The saphenous vein grafts (SVG) were used for CABG operation (30 patients).Group II: The left internal mammary artery (LIMA) graft was used only or with saphenous vein grafts for CABG operations and the pleura was left intentionally intact (30 patients).Group III: The LIMA graft was used only or with saphenous vein grafts for CABG operations and the pleura was opened (30 patients). ResultsWhen the 3 groups were compared together, it was found that, the mean values of Slow vital capacity (SVC), Forced vital capacity (FVC), and Forced expiratory volume in first second (FEV1) of group I were: 58.750 ± 10.325, 57.993 ± 6.425, and 61.914 ± 8.912 respectively and those of group II were: 40.901 ± 5.361, 39.355 ± 5.278, and 43.242 ± 9.126 and group III are 31.779 ± 6.99, 32.602 ± 4.731 and 34.638 ± 5.799 respectively, with P < 0.001 denoting a highly significant decrease in group III over group II & group I respectively. ConclusionCABG has a profound effect on pulmonary functions. The saphenous vein group showed the least reduction pulmonary functions followed by those LIMA patients with intact pleura.