Key result
Routing the left internal mammary artery through a trans pleural tunnel away from the midline protects the patent graft from injury during future sternal re-entry and mediastinal dissection.
Case Report
A novel surgical technique routing the LIMA through a trans pleural tunnel during primary CABG may protect the graft from injury during future redo-sternotomy.
May support LIMA protection in redo sternotomy; hypothesis-generating from Level 5 evidence and should not change practice.
With increase in long term survival after coronary artery bypass surgery and Left Internal Mammary Artery (LIMA) patency reaching up to 96% at 15 years, re-sternotomy for repeat cardiac surgery in the presence of a patent LIMA is not unusual [1]. Today, decades after the introduction of Coronary Artery Bypass Grafting (CABG) as a routine procedure in many medical centres, 1 in every 5 to 7 patients who have undergone one CABG may need a reoperation [2].
No takes yet. Share an insight, caveat, or question.
Mahmoud Abdelaziz (2018) conducted a case report in Coronary Artery Bypass Grafting (CABG). Trans pleural tunnel routing of the LIMA was evaluated. Routing the left internal mammary artery through a trans pleural tunnel away from the midline protects the patent graft from injury during future sternal re-entry and mediastinal dissection.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: