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Ann Thorac Surg 1995;60:1826-1828
© 1995 The Society of Thoracic Surgeons

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How to Do It

Protection of the Right Internal Mammary Artery in the Retrosternal Position With Stented Grafts

St. Vincent Medical Center, Toledo, Ohio

Accepted for publication July 10, 1995.

One of the limiting factors for the use of the right internal mammary artery as a pedicle graft to the anterolateral vessels of the left coronary system is the necessary midline crossover and the close proximity to the sternum. In this setting, the right internal mammary artery pedicle is at increased risk of injury during sternal reentry and dissection. A technique is described where stented polytetrafluoroethylene grafts were used to shield right internal mammary artery pedicles. There were no operative deaths or polytetrafluoroethylene-related complications. The right internal mammary artery was patent with its target vessel well perfused in 6 restudied patients.

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