Ata, Emin CanErkanlı Şentürk, GözdeSaygı, Halil İbrahimUlukan, Mustafa ÖzerUğurlucan, MuratErkanlı, KorhanBeyaz, Metin OnurYıldız, Erkan2022-11-282022-11-282022Ata, E. C., Erkanlı Şentürk, G., Saygı, H. İ., Ulukan, M. Ö., Uğurlucan, M., Erkanlı, K. ... Yıldız, E. (2022). Identifying the optimal monopolar electrocautery output power in pedicular internal thoracic artery harvesting: 20 or 40 watts? Cardiovascular Journal of Africa, 33(5), 243-247. https://doi.org/10.5830/CVJA-2022-0051995-18921680-0745https://doi.org/10.5830/CVJA-2022-005https://hdl.handle.net/20.500.12511/10040BACKGROUND: Monopolar electrocautery is an important tool for harvesting the pedicular internal thoracic artery (ITA) in cardiac surgery. The different power outputs of cautery may affect graft integrity and long-term patency. This study aimed to identify the optimal threshold of electrocautery power for ITA harvest. METHODS: This prospective study included 30 patients who underwent elective coronary artery bypass surgery at the Medipol Mega University Hospital. The ITA was harvested by monopolar electrocautery after a median sternotomy. The output of cautery was adjusted at 20 W in group A and 40 W in group B. Three to 4 cm of a distal ITA sample from each patient was examined under a light microscope by two independent pathologists. RESULTS: The ITA harvest time was longer in group A (21.2 ± 7.5 vs 10.3 ± 8.1 min, p < 0.001) than in group B. ITA free flow was similar in the two groups (43.6 ± 48.7 vs 51.7 ± 45.0 Ml/min, p = 0.762). Mild to moderate injury in the endothelial and sub-endothelial sample was more frequent in the low-cautery group (p = 0.0037). CONCLUSIONS: ITA endothelial integrity was found to be better preserved with 40W electrocautery. Moreover, 20W of monopolar electrocautery may not be safe in pedicular ITA harvesting.eninfo:eu-repo/semantics/embargoedAccessCoronary Artery BypassElectrocauteryEndothelial InjuryInternal Thoracic ArteryArticle33524324710.5830/CVJA-2022-005Q40007612915000012-s2.0-8514189074935211717Q3