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The Annals of Thoracic Surgery, Vol 46, 465-466, Copyright © 1988 by The Society of Thoracic Surgeons

ARTICLES

Coronary artery bypass grafting in patients with a tracheostoma: use of a bilateral thoracotomy incision

WG Marshall Jr, RL Meng and JL Ehrenhaft
Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO.

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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