The Harvesting Technique Affects the Production of Nitric Oxide and Endothelin in the Internal Thoracic Artery Graft

The authors conducted a randomized study involving 40 patients undergoing off-pump coronary artery bypass grafting (CABG) to compare techniques for preparing internal thoracic arteries. They found that skeletonized grafts showed endothelial disruption, reduced endothelial nitric oxide synthase staining, and lower plasma nitric oxide levels when compared with pedicled grafts without endothoracic fascia. Endothelin-1 release and EDN1 mRNA expression were significantly higher in skeletonized arteries. The authors concluded that skeletonization impairs endothelial integrity and shifts the nitric oxide-endothelin balance, which may negatively affect graft performance.