title: Redo left anterior descending artery grafting via left anterior small thoracotomy: an alternative approach.
abstract: Reoperative left anterior descending artery (LAD) revascularization can be performed through a left anterior small thoracotomy (LAST approach) in patients requiring isolated LAD revascularization. If the left internal mammary artery has been previously used, however, the operation is generally performed either through a median sternotomy or through a full posterolateral thoracotomy for the necessity of connecting the vein graft to the ascending aorta or to the descending thoracic aorta, thus losing the advantages of a minimally invasive approach. In the case reported herein, we describe a technique in which reoperative revascularization of the LAD is accomplished through the LAST approach, using the stump of the left internal mammary artery as the inflow site of a saphenous vein coronary graft to the LAD.
authors.affiliation: Division of Cardiothoracic Surgery, Buffalo General Hospital and SUNY at Buffalo, New York 14203, USA.
authors.forename: P C
authors.initials: PC
authors.lastname: Kerr
authors.forename: M
authors.initials: M
authors.lastname: Ricci
authors.forename: R
authors.initials: R
authors.lastname: Abraham
authors.forename: G
authors.initials: G
authors.lastname: D'Ancona
authors.forename: T A
authors.initials: TA
authors.lastname: Salerno
mesh_terms: D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D009204:Myocardial Revascularization / Q000379:methods*; D012086:Reoperation; D013908:Thoracotomy / Q000379:methods*