title: Protecting the crossover right internal thoracic artery bypass graft with a pedicled thymus flap.
abstract: The right internal thoracic artery graft is placed in jeopardy during repeat sternotomy as it crosses the aorta anteriorly to reach its left-sided coronary targets. We have devised a way of protecting it by means of a pedicled flap taken from the thymic remnants. The flap is easily developed without unduly increasing operative time and morbidity, and it is expected to prevent inadvertent injuries to the graft in the case of mediastinal reentry. Starting in 1999, suitable flaps were obtained in 955 of 1,034 patients (92.4%) receiving an anteaortic crossover right internal thoracic artery-to-coronary graft in our division.
authors.affiliation: Cardiovascular Department, Division of Cardiac Surgery, Ospedali Riuniti di Trieste, Trieste, Italy. giusep.gatti@tiscali.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gatti
authors.forename: Aniello
authors.initials: A
authors.lastname: Pappalardo
authors.forename: Livio
authors.initials: L
authors.lastname: Gon
authors.forename: Bartolo
authors.initials: B
authors.lastname: Zingone
mesh_terms: D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D008323:Mammary Arteries / Q000293:injuries*; D013524:Surgical Flaps; D013950:Thymus Gland / Q000601:surgery*; D014947:Wounds and Injuries / Q000517:prevention & control