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Ann Thorac Surg. 2000 May;69(5):1455-8.

Anterior intercostal nerve damage after coronary artery bypass graft surgery with use of internal thoracic artery graft.

Author information

1
Division of Cardiovascular Surgery, Toronto General and Toronto Western Hospitals, and University of Toronto Centre for the Study of Pain, Ontario, Canada. angela.mailis@uhn.on.ca

Abstract

BACKGROUND:

The prevalence of intercostal nerve damage associated with coronary artery bypass graft-internal thoracic (mammary) artery surgery is unknown.

METHODS:

A total of 37 consecutive patients with coronary artery bypass graft surgery (all with left internal thoracic artery graft) who were attending a cardiac-related exercise program underwent a thorough examination. Nerve damage was considered to be "definite" in the presence of two consistent and well-demarcated sensory abnormalities over the anterior chest wall within the T1 to T6 anterior intercostal nerve territory, and was considered "possible" in the presence of one such abnormality.

RESULTS:

Definite nerve damage was detected in 73% of the subjects, and possible nerve damage was found in another 11% at the site of internal thoracic artery harvesting. Protracted postoperative pain or unpleasant sensations, usually subsiding by 4 months, were reported by recollection by 81% of the subjects. Overall, the prevalence of persistent pain in those with definite nerve damage 5 to 28 months after surgery was 15%.

CONCLUSIONS:

Intercostal nerve damage seems to occur in three-quarters of all patients undergoing coronary artery bypass graft-internal thoracic artery surgery. A significant minority may continue to experience bothersome chronic chest wall pain.

PMID:
10881822
DOI:
10.1016/s0003-4975(00)01186-3
[Indexed for MEDLINE]

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