title: Free right internal thoracic artery in a "horseshoe" configuration: a new technical approach for "in situ" conduit lengthening.
abstract: Severe chronic obstructive pulmonary disease with large lung volumes may prevent both the "in situ" internal thoracic arteries to reach coronary anastomoses sites. We present a method to revascularize the left antero-lateral myocardial wall using the right internal thoracic artery as a "free graft" anastomosed side to end to the "in situ" left internal thoracic artery, in a "horseshoe" fashion. The two ends of the "free graft" were anastomosed to the left anterior descending coronary artery and the second obtuse marginal branch, respectively. This method was successfully used in a 74-year-old patient with severe chronic obstructive pulmonary disease.
authors.affiliation: Division of Cardiac Surgery, Tor Vergata University, Rome, Italy. zeitani@hotmail.com
authors.forename: Jacob
authors.initials: J
authors.lastname: Zeitani
authors.forename: Alfonso
authors.initials: A
authors.lastname: Penta de Peppo
authors.forename: Antonio
authors.initials: A
authors.lastname: Scafuri
authors.forename: Francesco
authors.initials: F
authors.lastname: Versaci
authors.forename: Luigi
authors.initials: L
authors.lastname: Chiariello
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D017130:Angioplasty / Q000379:methods*; D017023:Coronary Angiography; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000601:surgery; D006801:Humans; D008323:Mammary Arteries / Q000601:surgery*; D029424:Pulmonary Disease, Chronic Obstructive / Q000601:surgery; D014654:Vascular Patency