Bilateral Internal Mammary Artery Grafting in Diabetic Females - Incidence of Sternal Wound Infections: A Case Study

Bilateral Internal mammary artery grafting in diabetic females-Incidence of sternal wound infections-a case study Introduction Coronary artery bypass graft (CABG) surgery is the gold standard for revascularisation in patients with multivessel coronary artery disease. The left internal mammary artery (LIMA) and saphenous vein are the most commonly used conduits in CABG. However, recent studies suggest that use of bilateral IMA is associated with significantly better long-term outcomes. In spite of the benefits, most surgeons are reluctant to use both IMAs, because it is technically more demanding, time-consuming and is associated with marginally higher sternal wound infection rates. In our study the safety of using bilateral IMAs with regard to early postoperative outcomes with special reference to deep sternal wound infections has been addressed. Our study provides enough evidence to convince more surgeons about the advantages of bilateral IMA grafting especially in diabetic female patients. Results Postoperative recovery was uneventful in all 18 patients with no evidence of sternal wound related complications in early 30 days. All patients remained free of angina and early readmission. Conclusion: Although bilateral mammary artery (LIMA-RIMA Y) grafting is more technically demanding, its use in female patients has slightly more advantages because of the quality and wide lumen of mammary artery as internal mammary artery is habituated to supply and deal with high blood flow naturally as it also supplies mammary gland. As Coronary artery disease incidence is more in Fatty, obese, less mobile, bulky female patients, increased tissue and muscle mass in chest, mammary gland and upper abdomen makes high blood flow demanding situations through internal mammary artery. This makes internal mammary artery bound to become large and wide lumen, making it the perfect conduit of choice for coronary revascularization in these patients.