Key result
A new technique for reoperative LAD grafting using a left anterior small thoracotomy and connecting the graft to the right internal mammary artery is described for patients with a previously used LIMA.
Describes a novel 'H' graft technique from the RIMA to the LAD via a LAST approach for reoperative grafting in patients with prior LIMA use.
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May offer an alternative reoperative approach after prior LIMA; leaves open safety and efficacy pending prospective data.
Reoperative grafting of the left anterior descending (LAD) coronary artery or its diagonal branches can be accomplished through a left anterior small thoracotomy (LAST) on the beating heart using the left internal mammary artery (LIMA) as a conduit. Patients in whom the LIMA has been used previously, however, are generally excluded from this approach unless an alternative technique is utilized. We describe a new technique applicable to these patients that consists of grafting the LAD through a LAST approach and connecting the graft to the right internal mammary artery (RIMA).
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Ricci et al. (2001) studied Reoperative grafting of the LAD territory. "H" Graft from the RIMA to the LAD via left anterior small thoracotomy was evaluated. A new technique for reoperative LAD grafting using a left anterior small thoracotomy and connecting the graft to the right internal mammary artery is described for patients with a previously used LIMA.
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