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J Thorac Cardiovasc Surg 1997;114:686-687
© 1997 Mosby, Inc.

LETTERS TO THE EDITOR

The right internal thoracic artery for myocardial revascularization

Koji Ueyama, MD, Ryuzo Sakata, MD

Department of Cardiovascular Surgery
Kumamoto Central Hospital
1-16-1 Shinyashiki
Kumamoto 862, Japan

Reply to the Editor:

We were intrigued with Dr. Puig's response. We also believe that use of the right internal thoracic artery (ITA) via the transverse sinus to revascularize the circumflex area in coronary artery bypass operations is theoretically the best procedure.

Regarding indications for use of bilateral ITAs, our opinion on age limit differs from Dr. Puig's. Our age limit for bilateral ITAs is 75 years in Japan, because the average life span in Japan is 80 years. We assume that it is shorter in Brazil.

Since publishing our report in the Journal, we have continued to use this technique for selected patients. The total number of patients so treated as of November 28, 1996, is 215. Excellent long-term patency of the right ITA grafts via the transverse sinus in Dr. Puig's experience reinforces our results and gives us confidence in using this method.





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