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J Thorac Cardiovasc Surg 2002;124:1254-1255
© 2002 The American Association for Thoracic Surgery

Brief Communications

How to establish myocardial protection during aortic arch operation in patients with patent left internal thoracic artery graft: Careful dissection or no touch technique?

Masato Nakajima, MD, Kouji Tsuchiya, MD, Yuji Naito, MD, Narutoshi Hibino, MD, Hidenori Inoue, MD Kofu City, Japan

From the Department of Cardiovascular Surgery, Yamanashi Central Hospital, Kofu City, Yamanashi, Japan.

Received for publication April 23, 2002. Accepted for publication May 1, 2002. Address for reprints: Masato Nakajima, MD, Department of Cardiovascular Surgery, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu City, Yamanashi 400-0027, Japan (E-mail: m-nakajima2a@ych.pref.yamanashi.jp).

The first 20% of the full text of this article appears below.

There has been controversy regarding the management of the patent internal thoracic artery (ITA) as a coronary arterial graft during the operation for aortic arch aneurysm after coronary artery bypass grafting. We present a simple and effective method of myocardial protection with antegrade cold blood cardioplegia combined with cold blood perfusion of a patent graft through the subclavian artery without dissecting and touching the patent graft.

Clinical summary

We used this technique in the 2 patients described in Table 1.


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  		Table 1. Patient profiles
 
Selective angiographic evaluation of the patent ITA graft was performed before the operation to detect the relationship between the sternum and the ITA. The heart was approached through a repeat median sternotomy after the femoral artery was exposed. After careful dissection of . . . [Full Text of this Article]






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