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Ann Thorac Surg 2003;75:1065
© 2003 The Society of Thoracic Surgeons

Correspondence

Alternate technique of routing the in situ right internal mammary artery to graft the left anterior descending artery and its branches: Reply

Mohamed Amrani, FRCS, Sharif Al-Ruzzeh, FRCS, Shane George, FRCA, Mahmoud Bustami, MRCP, Koki Nakamura, MD, Charles Ilsley, FRCP

National Heart and Lung Institute, Harefield Hospital, Hill End Road, Middlesex UB9 6JH, UK

To the Editor:

We thank Dr Vassiliades for his nice comments regarding the article on the right pedicled internal mammary artery to the left anterior descending artery. The technique he describes is very elegant and has at least two advantages. One is that it is somehow buried behind the actual superior vena cava and the innominate and therefore, it is not directly exposed for re-do operation. In addition it probably provides more length. As mentioned in our article we never encountered any need for extra length of the right internal mammary artery. Longitudinal without transverse fasciotomy of the pedicled right internal mammary artery has always been enough to reach the portion of the left anterior descending artery we needed to reach. As far as the issue of re-do is concerned we always make sure that the right internal mammary artery is covered with thymic, pleural, or even peicardial tissue.





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