Risk of Sternal Wound Infection in Bilateral Skeletonized Internal Thoracic Artery in Coronary Artery Bypass Grafting: A Propensity Score Matching Analysis

In this article, the authors evaluated whether skeletonized bilateral internal mammary artery grafting increases sternal wound infection after isolated coronary artery bypass grafting (CABG). In a single-center retrospective cohort from Heidelberg, 1,785 CABG patients were screened. After exclusions, 1,193 remained, including 925 patients who underwent skeletonized internal mammary artery (SIMA) and 268 patients who underwent bilateral internal mammary artery (BIMA) grafting. Propensity score matching yielded 259 matched patients per group. Sternal wound infection occurred in only six patients overall, with identical rates after SIMA and BIMA grafting, each at 1.2 percent, which included two deep and four superficial infections. BIMA was not an independent risk factor for wound infection, with an odds ratio (OR) of 0.66 and a 95 percent confidence interval (CI) of 0.19 to 2.27. Instead, female sex, diabetes, New York Heart Association (NYHA) class ≥3, and postoperative delirium predicted infection.