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J Thorac Cardiovasc Surg 2000;120:616
© 2000 The American Association for Thoracic Surgery

Letters to the Editor

Assessment of sternal vascularity with single photon emission computed tomography after harvesting of the internal thoracic artery

South Cleveland Hospital
Marton Rd, Middlesbrough Cleveland TS4 3BW, United Kingdom

To the Editor:

As is inevitable in an international exchange of information, there seem to be semantic problems that obscure issues. Cohen and associates ¹ exemplify this in their article, in which they give the impression that we ² found no loss of sternal vascularity with nonskeletonized grafts. Their error was to translate the word "pedicled" as meaning the indiscriminate hacking down of the thoracic artery along with anything in its vicinity, so commonly done these days in the pursuit of speed. The word "pedicle" means a stalk, on a foot, and Rivas quite correctly described our grafts as pedicles, free from the fascia. Anyone who has read our description of the technique ³ will know that the artery is cleaned of all attachments right up to the subclavian, facilitated by the use of a well-designed retractor.

Our experience thus agrees with that of Cohen and associates in that our patients lost no sternal vascularity, the thoracic artery having actually been "skeletonized."

12/8/108283

doi:10.1067/mtc.2000.108283

References

1. Cohen AJ, Lockman J, Lorberboym M, Bder O, Cohen N, Medalion B, et al. Assessment of sternal vascularity with single photon computed tomography after harvesting of the internal thoracic artery. J Thorac Cardiovasc Surg 1999;118:496-502. [Abstract/Free Full Text]
   
2. Rivas LF, Hawkins T, Morritt GN, Behl RP, Griffin SC, Brown AH. Radiopharmaceutical uptake as a marker of sternal blood supply following internal mammary artery harvesting. Cardiovasc Surg 1994;2:203-6. [Medline]
   
3. Brown AH, Dougenis D. Dissection of the two internal mammary arteries with maximal exposure and minimal adverse sequelae by means of an inexpensive, simple, atraumatic retractor. J Thorac Cardiovasc Surg 1991;102:753-6. [Abstract]
   

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				A. Casha and M. Gauci Sternal vascularity after harvesting of the internal thoracic artery J. Thorac. Cardiovasc. Surg., June 1, 2001; 121(6): 1219 - 1219. [Full Text] [PDF]

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): A. Hedley Brown Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Brown, A. H. Search for Related Content PubMed PubMed Citation Articles by Brown, A. H.