Controvérsias em

Medicina Cardiovascular

2012

17 de abril 2012

MJR

Controvérsias em medicina cardiovascular

17 de abril 2012

MJR

O uso da "técnica esqueletizada"

versus “ técnica pediculada" para o

enxerto da artéria mamária

(unilateral ou bilateral)

Quais são os pros & cons?

Conversando sobre

Padrões e Qualificações

23 de abril 2012

MJR

Pediculada Esqueletizada

Literatura & opiniões

Literatura & opiniões

Artigos originais

Guidelines

.....“there is considerable debate about the optimal harvesting technique

for the ITA.”...

“disestesia”

“disestesia”

“disestesia”

“fluxo”

Does skeletonized harvesting of the ITA reduce

superficial and deep sternal wound infections?

Does skeletonized harvesting of the ITA reduce

superficial and deep sternal wound infections?

Is there a role for skeletonized harvesting of a

single ITA?

Does bilateral skeletonized harvesting of the ITA

improve outcomes other than sternal wound infection

in the diabetic population?

Does skeletonized harvesting of the ITA reduce

superficial and deep sternal wound infections?

The aim of this study is to assess whether SWI rates

are reduced when skeletonizing the ITA, if this

benefit extends to diabetic patients, and the impact

of skeletonizing BITA on SWI rates.

Todos os estudos, sumário

Em diabéticos

Mamária bilateral

Mamária bilateral em diabéticos

“3… when harvesting BITA, the advantage of skeletonization is maintained with a reduction of

postoperative SWI rates from 11.7% to 2.96% for all studies and from 14.2% to 2.4% in diabetic patients”

“4... The subgroup analyses demonstrate that the reduction in SWI rates is maintained for

the whole spectrum of postoperative SWI including mediastinitis.”

“1... our first finding is that the risk of all SWI decreases by 60% when

skeletonizing the ITA”

“2… this advantage is amplified in diabetic patients in which an even greater benefit was

demonstrated ( the incidence of SWI was reduced from 21.3% to 3.57%)”