Document Detail

Can internal thoracic arteries be used for both coronary artery bypass and breast reconstruction?
MedLine Citation:
PMID:  22899665     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Recently, the internal thoracic arteries have been preferentially used in autologous breast reconstruction at the levels of the third or fourth intercostal spaces. This may compromise future treatment of occult coronary disease. We hypothesized that internal thoracic artery length at the fourth intercostal space would allow both breast reconstruction and future coronary artery bypass grafting (CABG).
METHODS: Anatomic analysis of 20 female patients undergoing CABG was performed examining internal thoracic artery length from its origin to the third, fourth, fifth intercostal spaces and the left anterior descending (LAD) artery target.
RESULTS: The left internal thoracic artery was anastamosed to the LAD target at a mean length of 11.4 ± 1.4 cm. The mean lengths of the pedicled left internal thoracic artery from its origin to the third, fourth and fifth intercostal space were 8.5 ± 1.0, 10.9 ± 1.2 and 13.0 ± 1.4 cm, respectively. Therefore, the left internal thoracic artery length was adequate at the fourth intercostal space in 6 of 20 (30%) patients.
CONCLUSIONS: Dissection of the left internal thoracic artery to the fourth intercostal space would allow for concomitant use in CABG and breast reconstruction in one-third of cases. However, skeletonization of the internal thoracic artery at the level of the fourth intercostal space would be sufficient for CABG in all cases following autologous breast reconstruction.
Maria E Currie; Stephanie A Fox; Rebecca J Greer-Bayramoglu; Amanda J Fortin; Michael W A Chu
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Publication Detail:
Type:  Journal Article     Date:  2012-08-16
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  15     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-26     Completed Date:  2013-04-11     Revised Date:  2013-11-05    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  811-5     Citation Subset:  IM    
Division of Cardiac Surgery, Department of Surgery, University of Western Ontario, London Health Sciences Centre, London, ON, Canada.
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MeSH Terms
Aged, 80 and over
Coronary Artery Bypass / methods*
Feasibility Studies
Mammaplasty / methods*
Mammary Arteries / anatomy & histology,  surgery*
Middle Aged
Comment In:
Interact Cardiovasc Thorac Surg. 2012 Nov;15(5):815   [PMID:  23100549 ]

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