Redo left anterior descending artery grafting via left anterior small thoracotomy: an alternative approach |
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Authors: | Kerr P C Ricci M Abraham R D'Ancona G Salerno T A |
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Institution: | Division of Cardiothoracic Surgery, Buffalo General Hospital and SUNY at Buffalo, New York 14203, USA. |
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Abstract: | Reoperative left anterior descending artery (LAD) revascularization can be performed through a left anterior small thoracotomy (LAST approach) in patients requiring isolated LAD revascularization. If the left internal mammary artery has been previously used, however, the operation is generally performed either through a median sternotomy or through a full posterolateral thoracotomy for the necessity of connecting the vein graft to the ascending aorta or to the descending thoracic aorta, thus losing the advantages of a minimally invasive approach. In the case reported herein, we describe a technique in which reoperative revascularization of the LAD is accomplished through the LAST approach, using the stump of the left internal mammary artery as the inflow site of a saphenous vein coronary graft to the LAD. |
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