Abstract: Objective To evaluate the outcome of the skeletonized harvesting method of internal mammary artery （IMA） in coronary artery bypass grafting (CABG), and its apply. Methods Two hundred and seventyseven patients (diabetic 33）underwent myocardial revascularization. Left IMA (n=100) or both side of IMA (n=177) were totally skeletonized from the surrounding tissues just by use of the scissors and the titanium clips without the use of electrocautery during harvesting，both side of IMA were harvested in 21 diabetics. Five cases were done with nonextracorporeal circulation CABG and 272 cases were done with extracorporeal circulation CABG. Results The extracorporeal circulation time was 60 to 217min (average 90.1min), aortic clampping time was 30 to 160min(average 53.3min). Operative mortality was 2.2％（6/227）. The IMA grafting has revealed a good quality and blood flow was fluent enough to meet the myocardial need perioperatively. All patients had a disappearance of angina pectoris. Harvesting of both side of IMA in patients, even for those diabetes, had not revealed a higher sternum inflammation. Coronary angiography showed a good patency. Conclusion The skeletonized harvesting method of IMA has a good flow patency rate and a less sternum injury during the harvesting procedure. Harvesting both sides IMA is no longer a contraindication in diabetics.
Objective To investigate the growth, expansion, and metabolic characteristics of the human dermal fibroblasts cultured in a bioreactor with batch and medium exchange modes. Methods Human dermal fibroblasts separated from foreskin were seeded into a 1.5 liter CelliGen bioreactor with 5mg/ml of microcarriers. The cell growth, glucose consumption and lactate accumulation in both batch and medium exchange cultures were measured. Results The growth density of fibroblasts cultured in the bioreactor with medium-exchange mode reached 2.08×106 cell/ml, expande 29.7 folds, which was 1.81 times as high as that in batch culture. By comparison with the results obtained in T-flasks and spinners under the same medium-exchange conditions, the cell density in the bioreactor was 9.16 and 1.43 times as high as those in T-flasks and spinners respectively owing to that the limitation effect the attachment surface, nutrient exhaust, and by-product accumulation on the growth of fibroblasts in the bioreactor by using microcarriers, medium-exchange, as well as gas aeration was elimnated. Conclution The above results indicate that suspended cultures with microcarriers in bioreactors are an effective approach to rpovide large amounts of seeding cells for tissue engineering.