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Ann Thorac Surg 2007;83:1508-1512
© 2007 The Society of Thoracic Surgeons

New Technology

Superiority of Using Bipolar Radiofrequency Energy for Internal Mammary Artery Harvesting

Thomas A. Vassiliades, Jr, MDa,*, Ned Cosgriff, MDb, Amy Denham, BSEEb, Jessica Olson, MSMEb, Donald H. Maul, DVMc

a Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia
b Tyco Healthcare, Boulder, Colorado
c Pre-Clinical Research Services, Colorado State University, Fort Collins, Colorado

Accepted for publication August 4, 2006.

* Address correspondence to Dr Vassiliades, The Emory Clinic Bldg A, 1365A Clifton Rd NE, Suite 2100, Atlanta, GA30322 (Email: thomas.vassiliades{at}emoryhealthcare.org).

Presented at the Basic Science Forum of the Fifty-second Annual Meeting of the Southern Thoracic Surgical Association, Orlando, FL, Nov 10–12, 2005.

Purpose: The purpose of this study was to observe the acute effects of harvesting the porcine internal mammary artery using a novel bipolar (BP) radiofrequency energy device.

Description: The internal mammary artery from 16 porcine subjects was harvested using monopolar electrosurgery, BP electrosurgery, ultrasonic coagulation, and mechanical dissection with clips. Segments were evaluated with respect to endothelial function and integrity and the strength of side-branch sealing.

Evaluation: Adenosine triphosphate-induced relaxation was greatest with internal mammary artery segments harvested by bipolar electrosurgery in comparison with monopolar electrosurgery (p = 0.0271), ultrasonic coagulation in comparison with monopolar electrosurgery (p = 0.0047), and mechanical clipping in comparison with monopolar electrosurgery (p = 0.0381). The standard error of the mean failed to demonstrate any significant difference in epithelial disruption among the four treatment groups. Clips and bipolar electrosurgery exhibited the most secure ligations with burst pressures exceeding 350 mm Hg.

Conclusions: Internal mammary artery segments harvested using a novel BP electrosurgery retained a greater degree of endothelial function when compared with monopolar electrosurgery and ultrasonic coagulation. Side-branch sealing with BP electrosurgery was as secure as mechanical clips.




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S. D. Demertzis, M. W. Laschke, F. P.A. Siclari, and M. D. Menger
Non-robotic thoracoscopic internal mammary artery preparation in the pig. A training model
Interactive CardioVascular and Thoracic Surgery, August 1, 2008; 7(4): 556 - 559.
[Abstract] [Full Text] [PDF]


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