Ata, Emin CanSenturk, Gozde ErkanliSaygi, Halil IbrahimUlukan, Mustafa OzerUgurlucan, MuratErkanli, KorhanBeyaz, Metin Onur2024-09-182024-09-1820221995-18921680-0745https://doi.org/10.5830/CVJA-2022-005https://hdl.handle.net/20.500.12483/9122Background: Monopolar electrocautery is an important tool for harvesting the pedicular internal thoracic artery (ITA) in cardiac surgery. The different power outputs of cautery may affect graft integrity and long-term patency. This study aimed to identify the optimal threshold of electrocautery power for ITA harvest. Methods: This prospective study included 30 patients who underwent elective coronary artery bypass surgery at the Medipol Mega University Hospital. The ITA was harvested by monopolar electrocautery after a median sternotomy. The output of cautery was adjusted at 20 W in group A and 40 W in group B. Three to 4 cm of a distal ITA sample from each patient was examined under a light microscope by two independent pathologists. Results: The ITA harvest time was longer in group A (21.2 +/- 7.5 vs 10.3 +/- 8.1 min, p < 0.001) than in group B. ITA free flow was similar in the two groups (43.6 +/- 48.7 vs 51.7 +/- 45.0 ml/min, p = 0.762). Mild to moderate injury in the endothelial and sub-endothelial sample was more frequent in the low-cautery group (p = 0.0037). Conclusion: ITA endothelial integrity was found to be better preserved with 40W electrocautery. Moreover, 20W of monop-olar electrocautery may not be safe in pedicular ITA harvesting.eninfo:eu-repo/semantics/openAccesscoronary artery bypasselectrocauteryendothelial injuryinternal thoracic arteryArticle33524324710.5830/CVJA-2022-005352117172-s2.0-85141890749Q3WOS:000761291500001Q4