Free right internal thoracic artery in a "horseshoe" configuration: a new technical approach for "in situ" conduit lengthening.
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.
Zeitani
Jacob
J
Division of Cardiac Surgery, Tor Vergata University, Rome, Italy. zeitani@hotmail.com
Penta de Peppo
Alfonso
A
Scafuri
Antonio
A
Versaci
Francesco
F
Chiariello
Luigi
L
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