The negative effect of internal mammary harvesting on sternal perfusion is well known,
especially in diabetic subjects. Microdialysis previously showed increased lactate tissue
concentration after mammary artery preparation. Although high antibiotic concentration is of
utmost importance in this region, no study previously measured the effect of internal mammary
artery harvesting on target tissue antibiotic concentration.
Internal mammary artery harvesting imposes an additional risk for deep sternal wound
infection by impairing antibiotic tissue penetration. This effect is mediated by altered
perfusion patterns and may be seen in cephalosporin and/or Teicoplanin treatment.
To evaluate the impact of left internal mammary artery preparation on target tissue
antibiotic concentration of Cefazolin and Teicoplanin during cardiac surgery
This study is designed as an observational pharmacokinetic trial. Patients are their own
controls by measuring antibiotic concentration in different subcutaneous tissues.
Patients referred for coronary artery bypass grafting to the Department of Cardiothoracic
Surgery with planned unilateral left internal mammary artery preparation and a high risk
profile for deep sternal wound infections will be asked to participate in this trial.