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Radial artery from left subclavian artery in redo coronary artery bypass grafting
1Department of Cardiac Surgery, University G. D'Annuzio, Chieti, Italy.
Insights
In redo coronary artery bypass grafting, a left anterior thoracotomy offers a safer alternative to sternotomy. This approach successfully utilized a radial artery graft sourced from the left subclavian artery in two patients.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
Background:
- Redo coronary artery bypass grafting (CABG) often necessitates repeat median sternotomy, which carries significant risks.
- Left anterior thoracotomy is an alternative surgical approach to minimize risks associated with repeat sternotomy.
Observation:
- Two patients undergoing redo CABG presented with a patent left internal mammary artery graft to the left anterior descending artery, adhered to the sternum.
- A novel technique was employed using a radial artery graft, with the left subclavian artery serving as the blood source.
Findings:
- The described technique involving radial artery grafting from the left subclavian artery was successfully applied in these selected redo CABG cases.
- This method provides a viable arterial grafting option when left thoracotomy is indicated and sternotomy is to be avoided.
Implications:
- This surgical strategy offers a valuable alternative for specific redo CABG patients, enhancing safety by avoiding sternotomy.
- It demonstrates the successful use of radial artery grafts in conjunction with left thoracotomy for complex coronary revascularization.
Abstract:
In redo coronary artery bypass grafting a left anterior thoracotomy can be used, if necessary, to avoid a dangerous repeat median sternotomy. In 2 patients with a well-functioning left internal mammary artery graft to a left anterior descending artery attached to the sternum, a radial artery was used with the left subclavian artery as the blood source. This technique can be used successfully in selected cases when a left thoracotomy is advisable and an arterial graft is preferred to a saphenous vein.