title: Reoperative grafting of the LAD system using the LAST approach: technical details.
abstract: In patients in whom the left internal mammary artery (LIMA) has been previously utilized, reoperative grafting of the left anterior descending (LAD) or diagonal coronary arteries can be performed through a left anterior small thoracotomy (LAST) approach, utilizing the subclavian artery as inflow source. In such cases, however, the left upper lobe of the lung and the lingula may exert unwanted traction on the newly constructed coronary graft. Herein, we describe a detail of technique that eliminates this inconvenience.
authors.affiliation: Division of Cardiothoracic Surgery and the Center for Minimally Invasive Cardiac Surgery, Buffalo General Hospital and State University of New York at Buffalo, USA.
authors.forename: M
authors.initials: M
authors.lastname: Ricci
authors.forename: J
authors.initials: J
authors.lastname: Bergsland
authors.forename: G
authors.initials: G
authors.lastname: D'Ancona
authors.forename: T A
authors.initials: TA
authors.lastname: Salerno
authors.forename: H L
authors.initials: HL
authors.lastname: Karamanoukian
mesh_terms: D001026:Coronary Artery Bypass / Q000379:methods*; D006801:Humans; D012086:Reoperation; D013348:Subclavian Artery / Q000601:surgery; D013908:Thoracotomy / Q000379:methods