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Ann Thorac Surg 1994;58:843-844
© 1994 The Society of Thoracic Surgeons

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Articles

Surgical anatomy of the phrenic nerve and internal mammary artery

Department of Cardiac Surgery, Royal Victoria Hospital, and Department of Anatomy, Queen's University of Belfast, Belfast, Northern Ireland

Accepted for publication February 2, 1994.

^_* Address reprint requests to Mr Owens, Department of Cardiac Surgery, Royal Victoria Hospital, Grosvenor Rd, Belfast, BT 12 6 BA, Northern Ireland.

Dissection of the thoracic inlet was performed on 22 cadavers to determine the relationship of the phrenic nerve to the internal mammary artery as it passes from lateral to medial behind the first rib. On the left the nerve was found to cross superior to the artery and then medial to it in 14 of 22 specimens; on the right this was found in ten of 22 specimens. In all other specimens, it crossed inferior to the internal mammary artery. These findings demonstrate that there is no constant relationship between these structures, and emphasize the need for caution when dissecting the internal mammary artery at or above the level of the first rib.

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