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Ann Thorac Surg 2005;79:1769-1771
© 2005 The Society of Thoracic Surgeons

Case report

Avoidable Errors in Cardiac Surgery: Anastomosis of the Left Internal Mammary Artery to a Vein

Deepak Banerjee, MDa, Daniel Fusco, MDb, Jeffrey Green, MDc, George Eapen, MDa, Vigneshwar Kasirajan, MDb,*

a Division of Cardiology, Medical College of Virginia/VCU, Richmond, Virginia, USA
b Division of Cardiothoracic Surgery, Medical College of Virginia/VCU, Richmond, Virginia, USA
c Division of Cardiothoracic Anesthesia, Medical College of Virginia/VCU, Richmond, Virginia, USA

Accepted for publication October 30, 2003.

* Address reprint requests to Dr Kasirajan, VCU Health System, Cardiothoracic Surgery, MCV Campus, West Hospital, 7 Floor South Wing, PO Box 980068, Richmond, VA 23298-0068, USA
vkasiraj{at}vcu.edu

We report the case of a patient who had undergone a three-vessel coronary artery bypass graft surgery 6 years earlier, during which the left internal mammary artery was erroneously anastomosed to an epicardial vein instead of the intended target, an intramyocardial left anterior descending artery. Visually distinguishing artery from vein can be occasionally challenging and can lead to errors in distal anastomosis. This case report identifies two difficult problems in cardiac surgery and discusses the techniques to differentiate between arterial and venous targets.






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Copyright © 2005 by The Society of Thoracic Surgeons.