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Left thoracotomy for coronary bypass in a patient with pectus excavatum

C Choghari1, O Heymans, M Geens

  • 1Department of Cardiovascular Surgery, Hôpital Civil de Jumet, Brussels, Belgium.

The Annals of Thoracic Surgery
|October 1, 1996
PubMed

Insights

Anterolateral thoracotomy is a viable surgical approach for patients with pectus excavatum undergoing coronary artery bypass grafting. This technique facilitates internal mammary artery harvesting and improves cardiac exposure.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Cardiac Anesthesia

Background:

  • Pectus excavatum poses surgical challenges for coronary artery bypass grafting (CABG) via median sternotomy.
  • Internal mammary artery (IMA) grafting is a preferred method for CABG due to its long-term patency.
  • Median sternotomy is the standard approach for CABG, but can be complicated by pectus excavatum.

Observation:

  • Median sternotomy is often difficult or impossible in patients with pectus excavatum.
  • An alternative surgical approach is needed to safely perform CABG in these patients.
  • The anterolateral thoracotomy offers a potential solution.

Findings:

  • The anterolateral thoracotomy approach was successfully employed in a patient with pectus excavatum.
  • This technique allowed for the harvesting of the internal mammary artery.
  • Excellent exposure of the anterolateral aspect of the heart was achieved.

Implications:

  • Anterolateral thoracotomy may be a valuable alternative for CABG in pectus excavatum patients.
  • This approach can enable the use of the internal mammary artery in challenging anatomies.
  • Further studies are warranted to evaluate the broader applicability and outcomes of this technique.

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