Document Detail

Thoracoscopic mammary artery mobilization in redo minimally invasive coronary bypass operations.
MedLine Citation:
PMID:  10543564     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It has been stated that thoracoscopic internal thoracic artery (ITA) mobilization is not recommended in the redo minimally invasive direct coronary artery bypass (MIDCAB) situation, presumably because adhesions from the previous coronary artery bypass grafting operation may preclude a thoracoscopic approach. However, there are advantages to thoracoscopic ITA mobilization in MIDCAB that could also be realized in the redo situation. METHODS: In 200 MIDCAB procedures over the last 3 and a half years, 11 patients, ages 49-83 (mean 69), were identified as having undergone an attempted ITA mobilization in a redo situation. RESULTS: Thoracoscopic ITA mobilization was successful in 9 out of 11 patients (81%). One patient had complete pleural symphysis precluding this approach, and 1 patient had poor mammary flow after harvest and this conduit was not used. Both failures were in female octogenarians. CONCLUSIONS: To realize the advantages of a thoracoscopic ITA mobilization MIDCAB, both right and left thoracoscopic ITA mobilization can safely be performed in the redo situation. Thoracic adhesions precluding a thoracoscopic approach were encountered in only 1 of 11 redo coronary artery bypass grafting patients.
R K Wolf; K Miyaji; J B Flege
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  68     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-11-09     Completed Date:  1999-11-09     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:  1540-1     Citation Subset:  AIM; IM    
Department of Cardiac Surgery, The Christ Hospital, Cincinnati, Ohio, USA.
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MeSH Terms
Aged, 80 and over
Coronary Artery Bypass / instrumentation*
Graft Occlusion, Vascular
Middle Aged
Myocardial Revascularization / instrumentation*
Surgical Instruments

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

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