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Ann Thorac Surg 2001;71:384-385
© 2001 The Society of Thoracic Surgeons

How to do it

Redo left anterior descending artery grafting via left anterior small thoracotomy: an alternative approach

Paul C. Kerr, DO, FACSa, Marco Ricci, MD, PhDa, Reginald Abraham, MDa, Giuseppe D’Ancona, MDa, Tomas A. Salerno, MDb

a Division of Cardiothoracic Surgery, Buffalo General Hospital and SUNY at Buffalo, Buffalo, New York, USA
b Division of Cardiothoracic Surgery, University of Miami/Jackson Memorial Hospital, Miami, Florida, USA

Accepted for publication June 4, 2000.

Address reprint requests to Dr Kerr, Division of Cardiothoracic Surgery, Buffalo General Hospital, 100 High St, Buffalo, NY 14203

Reoperative left anterior descending artery (LAD) revascularization can be performed through a left anterior small thoracotomy (LAST approach) in patients requiring isolated LAD revascularization. If the left internal mammary artery has been previously used, however, the operation is generally performed either through a median sternotomy or through a full posterolateral thoracotomy for the necessity of connecting the vein graft to the ascending aorta or to the descending thoracic aorta, thus losing the advantages of a minimally invasive approach. In the case reported herein, we describe a technique in which reoperative revascularization of the LAD is accomplished through the LAST approach, using the stump of the left internal mammary artery as the inflow site of a saphenous vein coronary graft to the LAD.




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M. Ricci and T. A. Salerno
Off-pump coronary reoperations via left thoracotomy: Reply
Ann. Thorac. Surg., June 1, 2001; 71(6): 2087 - 2088.
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