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J Thorac Cardiovasc Surg 2008;136:222-223
© 2008 The American Association for Thoracic Surgery

Brief Communication

The use of LigaSure for preservation of a previous coronary artery bypass graft by using the left internal thoracic artery in a left upper lobectomy

Mario Santini, MD*, Alfonso Fiorello, MD, Giovanni Vicidomini, MD, PhD, Paolo Laperuta, MD

Department of Thoracic Surgery, Second University of Naples, Naples, Italy

Received for publication November 16, 2007; accepted for publication December 9, 2007.

* Address for reprints: Mario Santini, MD, Chirurgia Toracica–Seconda Università di Napoli Piazza Miraglia, 2, I-80138 Naples, Italy. (Email: mario.santini@unina2.it).

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

We report an interesting clinical case concerning the use of an electrothermal bipolar tissue-sealing system (LigaSure, Valleylab, Inc, Boulder, Colo)1Go in a particularly challenging technical situation, such as the resection of the left upper pulmonary lobe in a patient with a previous coronary artery bypass graft (CABG) with the left internal thoracic artery (LITA).

Clinical Summary

In a 63-year-old man, an opacity localized in the left upper pulmonary lobe was incidentally discovered on chest radiographic analysis. He had undergone CABG 8 years before with the LITA on the left anterior descending coronary artery. Clinical and laboratory evaluation showed no abnormalities. Spirometric results were normal. Computed tomographic analysis demonstrated a peripheral mass in the left upper lobe, and there was no significant mediastinal adenopathy. Bronchoscopy did not demonstrate abnormalities of the left upper bronchus, and percutaneous needle biopsy showed a non–small cell lung cancer (NSCLC). A standard posterolateral thoracotomy incision was performed through the fifth intercostal space. A 6-cm tumor was found in the left upper lobe (Go . . . [Full Text of this Article]




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