title: Inferior T hemisternotomy after previous bypass grafting with the in situ RITA in front of the aorta.
abstract: Aortic valvular surgery is often challenging in patients with coronary artery bypass (CABG) using in situ right internal thoracic artery (RITA) crossing in front of the aorta to the left anterior descending artery (LAD). Full sternotomy and aortic dissection result sometimes in graft injury and subsequent myocardial ischemia. The benefit of an inferior T hemisternotomy through the second intercostal space is discussed. The grafts are neither dissected nor clamped, and the access to the aortic root is excellent. Graft lesions are avoided. The absence of graft clamping does not seem to impair the myocardial function.
authors.affiliation: Department of Cardiovascular Surgery, Professor Jegaden, Hôpital Pradel, Université Claude Bernard, Bron, France. fadi.farhat@chu-lyon.fr
authors.forename: Fadi
authors.initials: F
authors.lastname: Farhat
authors.forename: Stéphane
authors.initials: S
authors.lastname: Aubert
authors.forename: Pascal
authors.initials: P
authors.lastname: Rosamel
authors.forename: Olivier
authors.initials: O
authors.lastname: Jegaden
mesh_terms: D000368:Aged; D001011:Aorta / Q000601:surgery; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries; D012086:Reoperation / Q000379:methods; D013249:Sternum / Q000601:surgery*; D019737:Transplants; D016896:Treatment Outcome