Surgical methods
Most patients underwent OPCAB through a median full sternotomy and
patients underwent MIDCAB through fourth or fifth intercostal incision.
The pericardium was opened and suspended to expose the heart and the
heart was displaced using a posterior pericardial stitch and gauze
swabs. Patients lacking good presentation of the target arteries on the
lateral and inferior aspect of the heart were placed in a gentle right
decubitus Trendelenburg position to assist in visualization.
Stabilization of the target coronary arteries was accomplished with a
tissue stabilizer (Octopus, Medtronic Corporation, Minneapolis, MN). An
intra-coronary shunt (Medtronic Corporation, Minneapolis, MN) was used
during grafting in most operations. In this study, the LIMAs were all
harvested by the pedicle method. The SVG were harvested by open
harvesting method and endoscopic vein harvesting method.
Preoperative
internal mammary artery ultrasonography examination
Preoperative blood flow parameters of IMAs were measured by
transthoracic doppler ultrasonography machine (APLIO500 TUS-A500, Probe:
PLT-704SBT and PVT-712BT). All preoperative internal mammal artery
ultrasonography was performed by the same senior ultrasonologist.