The Use of Arterial Grafts of the Left Internal Mammary Artery is Not a Predictor for the Incidence of Pericardial Effusion

Abstract

BACKGROUND: The left internal mammary artery (LIMA) is used very often for coronary artery bypass grafting (CABG). During the cardiac surgery, surgical preparation of LIMA graft could be the reason for mediastinal bleeding and pericardial effusion (PE).
 AIM: This current study was, therefore, undertaken to show the prediction of PE occurrence comparing the usage of LIMA and venous graft.
 METHODOLOGY: The study population comprised 1929 patients (1.562 men mean age 57.1 years) who underwent CABG due to coronary disease. Patients were separated into two groups: Patients with venous and patients with arterial grafts on left anterior descending (LAD) artery. The first group included 1468 patients with arterial graft (LIMA) who underwent surgery from October 2008 to January 2014 and the second group included 461 patients with venous graft on LAD that were treated before 2008. Both groups were compared with respect to occurrences, size, and location of PE, which was determined on the 5th day after surgery by echocardiography.
 RESULTS: PE was identified in 1219 (63.1%) patients. There was no difference between compared groups in the proportional occurrence or absence of effusion: In the first group 931 (63.4%) and in the second 288 (62.4%) patients had PE (p > 0.05). There were significant differences (p < 0.001) in localization of effusion; circular effusion was found in 797 (41.3%) patients while localized effusion in 422 (21.8%) patients.
 CONCLUSION: Surgical experience can lead to a reduced risk of occurrence of PE when using arterial graft with no differences compared to using a venous graft. The use of arterial LIMA graft is not a predictor for the incidence of PE.