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Ann Thorac Surg 2006;81:1945-1946
© 2006 The Society of Thoracic Surgeons

Correspondence

Reply

Pankaj Saxena, MCh, DNB, Robert Tam, FRACS

Department of Cardiothoracic Surgery, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD 4032 Australia

(Email: drpankajsaxena{at}hotmail.com).

To the Editor:

The comments made by Nair and co-workers [1] regarding our technique of hydrodissection are interesting. However we would like to add that we used our technique to hydrodissect and develop a plane in the chest wall for the harvesting of the internal thoracic artery (ITA) as a skeletonized graft [2], in contrast to their method of pedicle harvesting of the graft [3]. In our initial few dissections with the use of papaverine, we found that local infiltration of the vasodilator caused dilatation of the small branches and bleeding, which caused difficulty in skeletonizing the conduit. Moreover it has been shown that vasospasm is avoided and the graft flows are better in skeletonized ITAs and are comparable with pedicle ITAs with intraluminal papaverine injection [4]. We congratulate the authors on their extensive experience with a useful technique.


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 References
 

  1. Nair UR, Javangula K, Mulay AV. Papaverine dissection for harvesting internal mammary artery (letter) Ann Thorac Surg 2006;81:1945.[Free Full Text]
  2. Saxena P, Mejia R, Tam R. Hydrodissection technique of harvesting left internal thoracic artery Ann Thorac Surg 2005;80:355-356.[Abstract/Free Full Text]
  3. Mulay AV, Dev KK, Nair RU. Prevention of internal thoracic artery spasm Ann Thorac Surg 1997;64:564.[Abstract/Free Full Text]
  4. Choi JB, Lee SY. Skeletonized and pedicle internal thoracic artery graftseffects on free flow during bypass. Ann Thorac Surg 1996;61:909-913.[Abstract/Free Full Text]

Related Article

Papaverine Dissection for Harvesting Internal Mammary Artery
Unnikrishnan R. Nair, Kalyana Javangula, and Anvay V. Mulay
Ann. Thorac. Surg. 2006 81: 1945. [Extract] [Full Text] [PDF]




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