Journal article
Left Thoracotomy for Reoperative Coronary Artery Bypass Procedures
The Annals of thoracic surgery, v 40(1), pp 11-15
Jul 1985
PMID: 3874613
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
This paper describes our experience in performing saphenous vein bypass grafts to the circumflex coronary artery system with a left thoracotomy in 9 patients. Illustrative case reports demonstrate the spectrum of patients for whom this approach has been useful. The advantage of this technique is that it allows the surgeon to avoid the adhesions that make a redo sternotomy time-consuming and potentially dangerous when previously patent saphenous vein or internal mammary grafts are present. It is particularly useful for patients requiring grafting to the circumflex coronary artery system, especially if the patient is in relatively unstable condition and would benefit from rapid institution of cardiopulmonary bypass. The technique generally employs cannulation of the descending thoracic aorta for arterial inflow and of the main pulmonary artery for venous return. Usually the proximal end of the graft is easily placed to the left subclavian artery. Coronary anastomosis is performed on the cold (15°C), fibrillating heart, and aortic cross-clamping and cardioplegic arrest have not been necessary. Venting is possible through the left atrial appendage should any rise in filling pressures occur. Saphenous vein or internal mammary artery may be used. All patients undergoing this technique have had expeditious discharge from the hospital and excellent relief of symptoms. The technique is an alternative to median sternotomy for properly selected patients.
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Details
- Title
- Left Thoracotomy for Reoperative Coronary Artery Bypass Procedures
- Creators
- Ross M. Ungerleider - Ochsner Medical CenterNoel L. Mills - Ochsner Medical CenterAndrew S. Wechsler - Ochsner Medical Center
- Publication Details
- The Annals of thoracic surgery, v 40(1), pp 11-15
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine; [Retired Faculty]
- Web of Science ID
- WOS:A1985ALG1500004
- Scopus ID
- 2-s2.0-0021947035
- Other Identifier
- 991020705489704721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery