HOW TO RECYCLE A MISUSED LEFT INTERNAL THORACIC ARTERY: TIPS AND TRICKS

In this case report we describe how to recycle the Left Internal Thoracic Artery (LITA) when misused but not damaged. 8 years after a Left Anterior Small Thoracotomy followed by LAD stenting for STEMI in 1st post-operative day, a 67 years old woman had a NSTEMI with angiographic evidence of intra-stent re-stenosis with a perfectly patent LITA, harvested only from the 4th to the 6th intercostal space. During redo surgery, LITA was harvested as a pedicle from the anastomosis to the 4th intercostal space and primarily from the 1st to the 4th intercostal space. Special attention was paid at the level of the 4th intercostal space where the vessel was stuck to the sternum: a 15 blade was used being scissors or cautery too dangerous. At the end of harvesting, the LITA was full-length available for a new coronary anastomosis on LAD, distal to the previous one.

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Percutaneous transluminal coronary angioplasty of the left internal thoracic artery graft: a case report in a child

Catheterization and Cardiovascular Diagnosis ◽

10.1002/ccd.1810320410 ◽

1994 ◽

Vol 32 (4) ◽

pp. 340-342 ◽

Cited By ~ 9

Author(s):

Tetsuji Kawata ◽

Junichi Hasegawa ◽

Yoshitsugu Yoshida ◽

Yoshiro Yoshikawa ◽

Kanji Kawachi ◽

...

Keyword(s):

Case Report ◽

Coronary Angioplasty ◽

Internal Thoracic Artery ◽

Percutaneous Transluminal Coronary Angioplasty ◽

Left Internal Thoracic Artery ◽

Artery Graft ◽

Transluminal Coronary Angioplasty ◽

Percutaneous Transluminal ◽

Internal Thoracic Artery Graft

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An L-Shaped Incision for an Extensive Thoracic Aortic Aneurysm and Coronary Artery Bypass Using the Left Internal Thoracic Artery

Aorta ◽

10.12945/j.aorta.2015.14-061 ◽

2015 ◽

Vol 03 (02) ◽

pp. 86-89 ◽

Cited By ~ 1

Author(s):

Tomonobu Abe ◽

Hiroto Suenaga ◽

Hideki Oshima ◽

Yoshimori Araki ◽

Masato Mutsuga ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass ◽

Internal Thoracic Artery ◽

Artery Bypass ◽

Left Lung ◽

Intercostal Space ◽

Descending Aorta ◽

Left Internal Thoracic Artery ◽

Heparin Administration ◽

Lateral Thoracotomy

AbstractAn L-shaped incision combining an upper half mid-sternotomy and a left antero-lateral thoracotomy at the fourth intercostal space has been proposed by several authors for extensive aneurysms involving the aortic arch and the proximal thoracic descending aorta. This approach usually requires the division of the left internal thoracic artery at its mid position, thus making it unusable for coronary artery bypass. We herein report a modified surgical approach for simultaneous extensive arch and proximal thoracic descending aorta replacement and coronary artery bypass using the left internal thoracic artery combining a left antero-lateral thoracotomy at the sixth intercostal space and upper mid-sternotomy. The visualization of the whole diseased aorta down to the level below the hilum of the left lung was good, and the integrity of the left internal thoracic artery graft was preserved by early heparin administration before sternotomy.

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