title: Surgical approach to aortic valve replacement after previous bilateral internal thoracic artery grafting.
abstract: The authors present a manubrium-sparing sternotomy technique for aortic valve replacement in patients who have undergone previous myocardial revascularization with both internal thoracic arteries. They have found that preoperative 64-multislice computed tomographic imaging facilitates surgical planning by delineating the course of patent grafts and, in particular, the relationship between the sternum and the right internal thoracic artery graft. A manubrium-sparing sternotomy can in such instances avoid injury to the right internal thoracic artery graft during both resternotomy and adhesion dissection, thus reducing surgical risk and operative time.
authors.affiliation: Division of Cardiac Surgery, Tor Vergata University of Rome, 00133 Rome, Italy.
authors.forename: Jacob
authors.initials: J
authors.lastname: Zeitani
authors.forename: Marta
authors.initials: M
authors.lastname: Pugliese
authors.forename: Charles Mve
authors.initials: CM
authors.lastname: Mvondo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Chiariello
authors.forename: Kiriakos
authors.initials: K
authors.lastname: Bellos
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
authors.forename: Luigi
authors.initials: L
authors.lastname: Chiariello
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D017023:Coronary Angiography / Q000379:methods; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D056346:Sternotomy / Q000379:methods*; D016896:Treatment Outcome
keywords: Aortic valve/surgery; coronary artery bypass/adverse effects; heart valve prosthesis implantation/methods; internal mammary-coronary artery anastomosis; intraoperative complications; reoperation; sternum/surgery; surgical procedures, minimally invasive/methods; thoracic arteries/injuries/transplantation