Document Detail


Technique for reoperative median sternotomy in the presence of a patent left internal mammary artery graft.
MedLine Citation:
PMID:  8012099     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Damage to a patent left internal mammary artery (IMA) graft during reoperation can be catastrophic. An organized approach to reenter the mediastinum in the presence of a functioning left IMA graft is described. The sternum is opened using an oscillating saw to carefully divide the anterior and posterior tables. The right side is then dissected out first, exposing the aorta and right atrium. After placing pursestring sutures for cannulation, attention is turned to the left side. An IMA retractor is used to elevated the left edge of the sternum in incremental stages. The dissection is begun at the inferior end of the sternum, exposing the distal anastomosis first and then dissecting superiorly anterior to the IMA. A Doppler flow detector probe is used to assist in locating the artery in the adhesions.
Authors:
A Elami; H Laks; G Merin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  9     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-07-26     Completed Date:  1994-07-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  123-7     Citation Subset:  IM    
Affiliation:
Division of Cardiothoracic Surgery, UCLA School of Medicine.
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Bypass / adverse effects*,  instrumentation,  methods*
Dissection
Humans
Intraoperative Complications / prevention & control*
Mammary Arteries / injuries*,  transplantation*,  ultrasonography
Monitoring, Intraoperative / methods
Reoperation / adverse effects*,  instrumentation,  methods*
Sternum / surgery*
Suture Techniques
Wounds and Injuries / etiology,  prevention & control

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


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