Which LIMA harvesting technique reduces the risk of sternal devascularization?

• A. Skeletonized LIMA harvest.
• B. Pedicled LIMA harvest only.
• C. Harvesting from the right side.
• D. Not harvesting LIMA at all.

Answer: (A)

Preserving blood supply to the sternum during LIMA harvest is essential to prevent sternal devascularization. When the left internal mammary artery is skeletonized, the artery is carefully dissected free from surrounding tissue, leaving the chest wall blood vessels and perforating branches that feed the sternum intact. This means the sternum keeps its perfusion even as the graft is prepared, reducing the risk of devascularization and related wound complications. In contrast, a pedicled harvest pulls more surrounding tissue and can disrupt those perforators, increasing the chance of compromising sternal blood flow. Harvesting from the right side or not harvesting LIMA at all does not address this issue and is not as protective for the sternum’s blood supply.