New surgical technique for harvesting the internal mammary artery.

Inadequate flow and limited length can be reasons for not using the internal mammary artery graft for myocardial revascularization. Several methods have been described to obviate these limitations, but each has disadvantages that contraindicate their application on a routine basis. Herein we describe what to the best of our knowledge is a new surgical technique of harvesting the internal mammary artery graft wherein the endothoracic fascia is incised longitudinally along the artery. In our experience, this surgical maneuver enables an increase in hematic flow (average, 30.6%) and in length of the graft (average, 10%) with reduced risk of damaging the arterial intima. This technique also enables the surgeon to detect the presence of atheromatous plaques and of parietal hematomas of the internal mammary artery wall. Moreover, we have observed a drastic reduction in the incidence of arterial spasms after use of this technique.