scholarly journals How to recycle a misused left internal thoracic artery: Tips and tricks

2021 ◽  
Author(s):  
Monica Contino ◽  
Massimo G. Lemma ◽  
Andrea Mangini ◽  
Claudia Romagnoni ◽  
Paolo Vanelli ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Tips And Tricks ◽  
Left Internal Thoracic Artery

scholarly journals HOW TO RECYCLE A MISUSED LEFT INTERNAL THORACIC ARTERY: TIPS AND TRICKS

2021 ◽  
Author(s):  
monica contino ◽  
Massimo Lemma ◽  
andrea mangini ◽  
claudia romagnoni ◽  
Paolo Vanelli ◽  
...  
Keyword(s):  
Case Report ◽  
Internal Thoracic Artery ◽  
Full Length ◽  
Intercostal Space ◽  
Redo Surgery ◽  
Tips And Tricks ◽  
Left Internal Thoracic Artery ◽  
Angiographic Evidence ◽  
Coronary Anastomosis

In this case report we describe how to recycle the Left Internal Thoracic Artery (LITA) when misused but not damaged. 8 years after a Left Anterior Small Thoracotomy followed by LAD stenting for STEMI in 1st post-operative day, a 67 years old woman had a NSTEMI with angiographic evidence of intra-stent re-stenosis with a perfectly patent LITA, harvested only from the 4th to the 6th intercostal space. During redo surgery, LITA was harvested as a pedicle from the anastomosis to the 4th intercostal space and primarily from the 1st to the 4th intercostal space. Special attention was paid at the level of the 4th intercostal space where the vessel was stuck to the sternum: a 15 blade was used being scissors or cautery too dangerous. At the end of harvesting, the LITA was full-length available for a new coronary anastomosis on LAD, distal to the previous one.

scholarly journals 010-I * HOW TO RECYCLE A MISUSED LEFT INTERNAL THORACIC ARTERY: TIPS AND TRICKS

2013 ◽  
Vol 17 (suppl 2) ◽  
pp. S71-S71
Author(s):  
M. Contino ◽  
A. Mangini ◽  
C. Romagnoni ◽  
P. Vanelli ◽  
G. Gelpi ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Tips And Tricks ◽  
Left Internal Thoracic Artery

scholarly journals Spontaneous Spiral Dissection of Left Internal Thoracic Artery Graft

2015 ◽  
Vol 56 (3) ◽  
pp. 360-362 ◽  
Author(s):  
Seiji Koga ◽  
Satoshi Ikeda ◽  
Tomoo Nakata ◽  
Koji Maemura
Keyword(s):  
Internal Thoracic Artery ◽  
Left Internal Thoracic Artery ◽  
Artery Graft ◽  
Internal Thoracic Artery Graft

Postoperative flow characteristics of left internal thoracic artery grafts

1995 ◽  
Vol 59 (1) ◽  
pp. 154-162 ◽  
Author(s):  
Michihiro Nasu ◽  
Takashi Akasaka ◽  
Tsuyoshi Okazaki ◽  
Masahiko Shinkai ◽  
Hiroshi Fujiwara ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Flow Characteristics ◽  
Left Internal Thoracic Artery

All Internal Thoracic Artery Composite Graft Revascularization

2005 ◽  
Vol 13 (4) ◽  
pp. 357-360
Author(s):  
Hiroshi Izumoto ◽  
Kazuaki Ishihara ◽  
Tetsunori Kawase ◽  
Takayuki Nakajima ◽  
Hiroshi Satoh ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Coronary Vessels ◽  
Composite Graft ◽  
Entire Group ◽  
Efficient Design ◽  
Technical Feasibility ◽  
Left Internal Thoracic Artery ◽  
Composite Grafts ◽  
Artery Graft ◽  
The Right

The aim of this study was to determine the most efficient design of composite grafts and clarify the technical feasibility rate of composite grafting using internal thoracic artery exclusively in patients undergoing triple-vessel revascularization. Retrospective analysis of 104 consecutive patients was carried out. An in situ left internal thoracic artery graft for the left anterior descending artery area, with attachment of the right internal thoracic artery to the side of the left internal thoracic artery to revascularize the circumflex and right coronary vessels, was the most efficient graft design. The technical feasibility rate was 80% (83/104 patients). The mean number of distal anastomoses for the entire group was 3.8 ± 0.8 per patient. Intraoperative left internal thoracic artery flow rate was 91.6 ± 37.8 mL·min−1. With more experience, it is thought that the technical feasibility rate could be increased.

A case of poststernotomy pseudoaneurysm of the left internal thoracic artery

2008 ◽  
Vol 9 (4) ◽  
pp. 433-334
Author(s):  
Andrea Blasio ◽  
Francesco Maisano ◽  
Stefano Moriggia ◽  
Lorenzo Arcobasso ◽  
Ottavio Alfieri
Keyword(s):  
Internal Thoracic Artery ◽  
Left Internal Thoracic Artery

Left Internal Thoracic Artery Graft Assessment by Firefly Fluorescence Imaging for Robot-Assisted Minimally Invasive Direct Coronary Artery Bypass

2019 ◽  
Vol 14 (2) ◽  
pp. 144-150
Author(s):  
Yoshitsugu Nakamura ◽  
Miho Kuroda ◽  
Yujiro Ito ◽  
Takahiko Masuda ◽  
Shuhei Nishijima ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Minimally Invasive ◽  
Fluorescence Imaging ◽  
Coronary Artery Bypass ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Robot Assisted ◽  
Left Internal Thoracic Artery ◽  
Post Harvest

Objective The da Vinci Xi surgical system (Intuitive Surgical, Sunnyvale, CA, USA) cannot give tactile feedback to surgeons. This shortcoming may increase the risk of left internal thoracic artery (LITA) injury during its harvest. We utilized Firefly Fluorescence Imaging (Firefly) to assess LITA quality in robot-assisted minimally invasive direct coronary artery bypass (R-MIDCAB). Methods We retrospectively reviewed clinical records and intraoperative videos of 30 consecutive patients who underwent R-MIDCAB with LITA–left anterior descending (LAD) coronary bypass. All patients had post-harvest assessment of LITA blood flow by Firefly with 1 mL (2.5 mg/mL) of indocyanine green injection through a central line. Results Twenty-seven of the patients were male, mean age was 67.7 ± 10.7 years. In post-harvest assessment performed before transection of the distal LITA, blood flow in LITA was well visualized in 28 patients. In the remaining 2 patients, 1 had dissection and the other had severe spasm of the LITA. Firefly was also useful for locating LITA and LAD and for assessing blood flow of the graft after anastomosis. Time required for each Firefly assessment was approximately 20 seconds. There were no side effects or complications due to Firefly intraoperatively and postoperatively. Twenty-six patients had postoperative coronary computed tomography; LITA patency rate was 100% (26/26). Conclusion Firefly is fast, simple, and effective for locating and assessing flow in LITA and LAD before and after anastomosis in R-MIDCAB.

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