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Ann Thorac Surg 2004;77:1257-1261
© 2004 The Society of Thoracic Surgeons

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Original article: cardiovascular

Skeletonization does not influence internal thoracic artery innervation

^a Department of Cardiac Surgery, Catholic University, Rome, Italy
^b Institute of Human Anatomy, Catholic University, Rome, Italy

Accepted for publication September 8, 2003.

^* Address reprint requests to Dr Gaudino, Divisione di Cardiochirurgia, Policlinico Universitario A. Gemelli, Largo A. Gemelli 8, 00168 Rome, Italy
e-mail: mgaudino{at}tiscali.it

BACKGROUND: This study was designed to compare the effect of surgical harvesting on internal thoracic artery innervation and to assess the eventual presence of denervation supersensitivity in skeletonized grafts.

METHODS: Nineteen patients who underwent primary isolated coronary artery bypass grafting were randomly assigned to receive a skeletonized (n = 9) or pedicled (n = 10) internal thoracic artery graft. Immunohistochemical nerve localization using anti–S-100 protein, anti–160-kd neurofilament polypeptide and anti–tyrosine hydroxylase antibodies was performed on distal specimens of arteries to study vascular innervation. Moreover, endovascular vasoactive challenges using serotonin and methylergometrine were performed at early angiographic control to evaluate the eventual presence of denervation supersensitivity.

RESULTS: Quantitative analysis of immunohistochemical specimens revealed lack of difference in the number of positive cells between skeletonized and pedicled arteries for all the antibodies used. No difference in the reaction to serotonin and methylergometrine was found between skeletonized and pedicled arteries.

CONCLUSIONS: Skeletonization does not influence internal thoracic artery innervation.

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