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The use of internal mammary artery (IMA) grafts for coronary artery bypass may devascularize the sternum. We performed a literature review by searching the PubMed database for studies that assessed sternal perfusion after IMA harvesting. The majority of papers describe various techniques and compared (1) IMA harvest versus no IMA harvest, (2) single versus bilateral, and (3) skeletonized versus pedicled. Evidence is inconclusive as to whether single harvesting causes significant devascularisation and whether this is increased with bilateral harvesting. Sternal ischemia may also be a transient phenomenon. However, skeletonization may preserve perfusion more than pedicled harvesting, particularly in diabetic patients.

Original publication




Journal article


Ann Thorac Surg

Publication Date





1942 - 1953


Coronary Artery Disease, Diabetic Angiopathies, Humans, Internal Mammary-Coronary Artery Anastomosis, Ischemia, Postoperative Period, Randomized Controlled Trials as Topic, Sternum, Tissue and Organ Harvesting