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Ann Thorac Surg 2005;80:1532-1533
© 2005 The Society of Thoracic Surgeons

How to do it

Inferior T Hemisternotomy After Previous Bypass Grafting With the In Situ RITA in Front of the Aorta

Fadi Farhat, MD a , * , Stéphane Aubert, MD a , Pascal Rosamel, MD b , Olivier Jegaden, MD a

a Department of Cardiovascular Surgery, Professor Jegaden, Hôpital Pradel, Université Claude Bernard, Bron, France
b Department of Anesthesia, Professor Lehot, Hôpital Pradel, Bron, France

Accepted for publication April 20, 2004.

* Address reprint requests to Dr Farhat, Department of Cardiovascular Surgery, Unit 31, Professor Jegaden. Hôpital Pradel, Université Claude Bernard, INSERM E0226, 28, Ave du Doyen Lepine, 69677 Bron Cedex, France (Email: fadi.farhat{at}chu-lyon.fr).

Aortic valvular surgery is often challenging in patients with coronary artery bypass (CABG) using in situ right internal thoracic artery (RITA) crossing in front of the aorta to the left anterior descending artery (LAD). Full sternotomy and aortic dissection result sometimes in graft injury and subsequent myocardial ischemia. The benefit of an inferior T hemisternotomy through the second intercostal space is discussed. The grafts are neither dissected nor clamped, and the access to the aortic root is excellent. Graft lesions are avoided. The absence of graft clamping does not seem to impair the myocardial function.




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D. Glineur, C. Hanet, A. Poncelet, W. D'hoore, J.-C. Funken, J. Rubay, J. Kefer, P. Astarci, V. Lacroix, R. Verhelst, et al.
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[Abstract] [Full Text] [PDF]


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