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Case Reports
Surgical approach to aortic valve replacement after previous bilateral internal thoracic artery grafting.
- Jacob Zeitani, Marta Pugliese, Charles Mve Mvondo, Giovanni Chiariello, Kiriakos Bellos, Giovanni Simonetti, and Luigi Chiariello.
- Division of Cardiac Surgery, Tor Vergata University of Rome, 00133 Rome, Italy.
- Tex Heart Inst J. 2013 Jan 1;40(2):170-2.
AbstractThe authors present a manubrium-sparing sternotomy technique for aortic valve replacement in patients who have undergone previous myocardial revascularization with both internal thoracic arteries. They have found that preoperative 64-multislice computed tomographic imaging facilitates surgical planning by delineating the course of patent grafts and, in particular, the relationship between the sternum and the right internal thoracic artery graft. A manubrium-sparing sternotomy can in such instances avoid injury to the right internal thoracic artery graft during both resternotomy and adhesion dissection, thus reducing surgical risk and operative time.
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