Harmonic Scalpel for Internal Mammary Artery Harvest

Internal mammary artery (IMA) harvest by using a harmonic scalpel for coronary artery bypass grafting (CABG) have not been sufficiently evaluated. This review aimed to assess the outcomes of IMA harvest by a harmonic scalpel and to compare by conventional electrocautery. The study materials were based on literature retrieval. In total Eight articles describing IMA harvest by a harmonic scalpel for 1,893 patients, and pateints with IMA harvest by electrocautery were taken as controls. IMA harvest by a harmonic scalpel was associated with less thermal injury with potentially better preservation of the endothelial cells, satisfactory intraoperative IMA flow, and promising postoperative IMA patency. Apart from the harvesting merits, the harmonic scalpel had many other advantages in terms of clinical outcomes, such as decreased postoperative mortality and morbidity rates. Nevertheless, IMA harvesting by using a harmonic scalpel is associated with longer harvest time, prolonged operative time, and increased hospitalisation expenses. Therefore, they could be used in selected and non-emergent patients for CABG. Key Words: Coronary artery bypass grafting, Internal mammary artery, Surgical instruments.