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

Letters to the Editor

Reply

Department of Cardiovascular Surgery
Edith Wolfson Medical Center
PO Box 5 Holon 58100, Israel

Reply to the Editor:

Brown's technique of dissecting a bundle of just the thoracic artery and accompanying veins is in fact very similar to our skeletonized technique. ¹ This explains what we thought were divergent results in their later article. ² These results, obtained while including the thoracic veins in the bundle, tend to imply that sternal ischemia, identified after harvesting broader thoracic artery pedicles, is principally due to damage to nearby arterial channels, rather than passive congestion caused by harvesting the thoracic veins. We are currently completing a study of a group of patients to assess sternal vascularity after harvesting the thoracic vessels as a bundle—consisting only of the artery and accompanying veins. Our results appear to be completely consistent with those of Rivas and associates, ² implying that sternal ischemia after thoracic artery harvest is related to injury of adjacent arterial channels and not venous congestion.

12/8/108284

doi:10.1067/mtc.2000.108284

References

1. 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]
   
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]
   

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 Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Amram J. Cohen Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Cohen, A. J. Search for Related Content PubMed Articles by Cohen, A. J.