Comparing a New Technique of Combining Carbon-dioxide With Electrocautery With Usual Technique of Stand-alone Electrocautery for Taking Down Left Internal Mammary Artery for Coronary Artery Bypass(CABG)

NCT06155045 | Completed

• 1 other identifier: 95/2020
• Study Type: interventional
• Target: 46
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this study is to compare the efficacy of a new harvesting technique for an arterial conduit(LIMA - Left Internal Mammary artery) in patients undergoing Coronary artery bypass grafting. The researcher will compare the

1. 1.Time taken to harvest the artery
2. 2.Flow of blood between the two techniques

Conditions

Coronary Artery Disease; Coronary Artery Disease With Myocardial Infarction

Keywords

CABG, LIMA harvesting, CAD

Outcome Measures

Primary Outcomes (2)

• Operative time

  Time taken to perform the harvesting of the LIMA

  10-20 min

• Blood flow/min

  Post dividing of the LIMA: blood from the LIMA is measured for 1 min

  1 min

Study Arms (2)

Modified Carbo-dissection technique

EXPERIMENTAL

The carbo-dissection technique is performed using an improvised instrument that combines an electrocautery pencil (ValleylabTM Force FX electrocautery Pencil, Covidien, USA) with a CO2 mister blower (PerfX® Heart Lung pack Blower/Mister Kit, B L Lifesciences, Noida, India) and the instruments are fixed together using silk ties.The electrocautery is used in the coagulation mode at a setting of 10 to 15. The C02 flow is set at 2 to 3 litres/minute. Saline flow is adjusted to a level that does not hinder the effective coagulation but still prevents drying and desiccation of the tissues. Following the dissection of LIMA by the techniques mentioned above, blood flow from the harvested LIMA for one whole minute was noted(1 min post division of LIMA). The operative time required for LIMA dissection was also noted and entered. Patient's s demographic data were also collected and entered.

Procedure: Modified Carbo-dissection Technique

Conventional Arm

ACTIVE COMPARATOR

The conventional technique is performed using an electrocautery pencil (ValleylabTM Force FX electrocautery Pencil, Covidien, USA). The electrocautery is used in the coagulation mode at a setting of 10 to 15. Following the dissection of LIMA, blood flow from the harvested LIMA for one whole minute was noted(1 min post division of LIMA). The operative time required for LIMA dissection was also noted and entered. Patient's s demographic data were also collected and entered.

Procedure: Conventional Arm

Interventions

Modified Carbo-dissection Technique PROCEDURE

This technique comes the C02 blower with electrocautery. Thereby, producing vasodilatation due to the gas and dissection aided by the electrocautery.

Modified Carbo-dissection technique

Conventional Arm PROCEDURE

This technique uses only the electrocautery as conventional model

Conventional Arm

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Elective CABG
• Hemodynamically stable CAD patients

You may not qualify if:

• Re-operation, previous sternotomy (where LIMA is already dissected)
• concomitant valve operation, ventricular aneurysm resection
• other additional major cardiac procedures
• Patients with chronic obstructive pulmonary disease

Sponsors & Collaborators

• Government Medical College Kottayam: lead

Study Sites (1)

Government Medical College Kottayam

Kottayam, Kerala, 686008, India

Location

Related Publications (4)

• Gilbert S, Singh D, Sivakumar MK. Modified carbodissection: A new technique for harvesting the internal mammary artery. Multimed Man Cardiothorac Surg. 2017 Oct 29;2017. doi: 10.1510/mmcts.2017.018.

  PMID: 29300076 BACKGROUND

• Ozkan M, Koramaz I, Ulus AT, Tavil Y, Filizlioglu H, Baykan EC, Eryilmaz S, Inan B, Katircioglu SF, Ozyurda U. Effect of carbon dioxide insufflation on free internal thoracic artery flows: is it a vasodilator? J Thorac Cardiovasc Surg. 2004 Sep;128(3):354-6. doi: 10.1016/j.jtcvs.2003.11.006.

  PMID: 15354091 BACKGROUND

• Lee ME. Carbodissection of the internal thoracic artery pedicle. Ann Thorac Surg. 1988 Oct;46(4):470-1. doi: 10.1016/s0003-4975(10)64671-1.

  PMID: 3140750 RESULT

• Nair JTK, Sathanantham DK, Thomas JK. Comparison of conventional and modified carbo-dissection techniques for LIMA harvesting in CABG. Indian J Thorac Cardiovasc Surg. 2025 Feb;41(2):162-166. doi: 10.1007/s12055-024-01780-z. Epub 2024 Jul 15.

  PMID: 39822879 DERIVED

MeSH Terms

Conditions

Coronary Artery Disease; Coronary Artery Disease, Autosomal Dominant, 1

Condition Hierarchy (Ancestors)

Coronary Disease; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Diseases

Study Officials

• Dinesh Kumar Sathanantham, MBBS MS MCh

  Government Medical College Kottayam

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Resident in Dept. of Cardiovascular and Thoracic Surgery

Model Details: The interventional group was compared with the conventional group in terms of two parameters : 1) operative time 2) blood flow/min

Study Record Dates

• First Submitted: November 24, 2023
• First Posted: December 4, 2023
• Study Start: January 1, 2021
• Primary Completion: December 31, 2021
• Study Completion: December 31, 2021
• Last Updated: December 15, 2023

Record last verified: 2023-12

Data Sharing

• IPD Sharing: Will not share

Locations

IN (1)