How to recycle a misused left internal thoracic artery: Tips and tricks
Monica Contino1, Massimo G Lemma2, Andrea Mangini1
1Division of Cardiac Surgery, Department of Cardio-Vascular Surgery, ASST Fatebenefratelli-Sacco, Milan, Italy.
Journal of Cardiac Surgery
|June 19, 2021
Summary
This case report details recycling a left internal thoracic artery (LITA) graft for coronary artery bypass grafting. The technique successfully re-established arterial flow to the heart in a patient with previous stenting.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Vascular Grafting
Background:
- Coronary artery disease management often involves arterial grafts.
- Previous sternotomy and limited graft harvesting can pose challenges for repeat revascularization.
Observation:
- A 67-year-old woman with prior stenting developed in-stent restenosis.
- The initially harvested left internal thoracic artery (LITA) was patent but only partially utilized.
Findings:
- A novel technique was employed to fully harvest the previously underutilized LITA as a pedicle.
- Careful dissection at the sternal adhesion point using a 15-blade ensured vessel integrity.
- The recycled LITA provided sufficient length for a new anastomosis to the left anterior descending artery.
Implications:
- This method offers a viable option for graft salvage in complex coronary reoperations.
- It expands the utility of the LITA in patients requiring repeat bypass surgery.
- Preserves autologous tissue and potentially avoids the need for alternative conduits.
Keywords:
coronary artery disease
