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Ann Thorac Surg 1988;46:465-466
© 1988 The Society of Thoracic Surgeons

Articles

Coronary Artery Bypass Grafting in Patients with a Tracheostoma: Use of a Bilateral Thoracotomy Incision

William G. Marshall, Jr., M.D.*, Ronald L. Meng, M.D., Johann L. Ehrenhaft, M.D.

Divisions of Cardiothoracic Surgery, Washington University School of Medicine and The Jewish Hospital at Washington University Medical Center, St. Louis, MO, and the Division of Thoracic and Cardiovascular Surgery, University of Iowa, Iowa City, IA

Accepted for publication May 4, 1988.

* Address reprint requests to Dr. Marshall, do The Watson Clinic, Division of Thoracic Surgery, 1600 Lakeland Hites Blvd, Lakeland, FL 33804-5000

The performance of cardiac surgical procedures via median sternotomy in patients with a tracheostoma can present difficult problems, including stomal necrosis, mediastinitis, and inadequate operative exposure. Bilateral thoracotomy is an alternative approach in such patients. This approach separates the stoma from the operative field and provides satisfactory exposure for internal mammary artery dissection and performance of coronary artery bypass grafting.




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