Document Detail

Coronary artery bypass surgery by the transdiaphragmatic approach.
MedLine Citation:
PMID:  12238827     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The transdiaphragmatic approach is useful for reoperative coronary artery bypass grafting involving the right coronary artery because it does not require median sternotomy or cardiopulmonary bypass. METHODS: Twenty-one patients underwent coronary artery bypass surgery by the transdiaphragmatic approach. The ratio of first operations to reoperations was 7:14. The cause of reoperation was occlusion of a saphenous vein graft in 4 patients, right gastroepiploic artery graft failure in 3 patients, and a new sclerotic lesion in the right coronary artery in 7 patients. When the radial artery or saphenous vein was used, grafting extended from the origin of the gastroduodenal artery to the right coronary artery. RESULTS: None of the patients died during surgery. The sites of anastomoses were as follows: right coronary artery in 11 patients, right posterior descending artery in 9 patients, and the atrioventricular node artery in 1 patient. The following types of grafts were used: right gastroepiploic artery in 17 patients, saphenous vein in 2 patients, and radial artery in 2 patients. CONCLUSIONS: When reoperative coronary surgery involving the right coronary artery is necessary, the transdiaphragmatic technique is effective because it does not damage patent grafts placed during the primary operation.
Kenji Takahashi; Masahito Minakawa; Norihiro Kondo; Shigeru Oikawa; Masaharu Hatakeyama
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  74     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-19     Completed Date:  2002-10-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  700-3     Citation Subset:  AIM; IM    
Department of Cardiovascular Surgery, Aomori Rousai Hospital, Hachinohe, Japan.
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MeSH Terms
Aged, 80 and over
Arteries / transplantation
Coronary Angiography
Coronary Artery Bypass / methods*
Coronary Restenosis / radiography,  surgery*
Diaphragm / surgery
Middle Aged
Postoperative Complications / radiography,  surgery*
Reoperation / methods
Veins / transplantation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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