Title : New sternal retractor for harvesting of bilateral internal thoracic arteries
Abstract:
Internal thoracic artery (ITA) harvesting is an important surgical procedure in cardiovascular surgery. In recent decades, more and more patients are revascularized with grafts from both internal thoracic arteries, which has shown better long-term outcomes. Since Favaloro introduced the first sternal retractor manufactured specifically for harvesting both internal thoracic arteries in 1967, its design has undergone some modifications to facilitate the work of surgeons and reduce the intensity of trauma to the chest wall.
In this sense, the ideal ITA retractor should be easy to assemble and manipulate; furthermore, it should preferably be attached to the operating table and allow elevation and abduction of the hemisternum while minimizing traumatic injuries to the bone and soft tissues.
In 2016, using obsolete surgical equipment, we manufactured an ITA sternal retractor that self-attaches to the operating table that has greatly facilitated the harvesting of both thoracic arteries in our service. To date it has been used in 312 patients (our hospital is a center with low surgical volume) in which 417 arteries have been harvested. When compared with another separator previously used in our center (French IMA retractor), the one we present now, allowed us to reduce the duration of harvesting on both sides, reduce the incidence of bone trauma as well as bleeding during the procedure.
In addition to these benefits, the first ITA sternal retractor manufactured in Cuba has other advantages that allow it to compete with models designed in developed countries (Pemco-Rultract, USA), which can make it very attractive to health systems in poor countries, due to the low cost of its manufacture.
