title: Reduced left internal mammary artery blood flow on normal sternal retraction.
abstract: The left internal mammary artery is the conduit of choice for bypassing the left anterior descending artery. A 72-year-old man underwent off-pump triple-vessel coronary artery bypass. The left internal mammary artery was harvested with brisk blood flow from the distal artery on completion of harvesting, but normal sternal retraction with a Medtronic OctoBase retractor led to cessation of flow. A vein graft was utilized for the left anterior descending artery, and the internal mammary artery was grafted to the first diagonal branch. Computed tomography-angiography on postoperative day 5 demonstrated no possible cause of the reduced flow on sternal retraction.
authors.affiliation: Department of Cardiothoracic Surgery, Fortis Hospital, Mohali, India kunal.kotkar@gmail.com.
authors.forename: Kunal Deepak
authors.initials: KD
authors.lastname: Kotkar
authors.affiliation: Department of Cardiothoracic Surgery, Fortis Hospital, Mohali, India.
authors.forename: Ambuj
authors.initials: A
authors.lastname: Chaudhary
authors.affiliation: Department of Cardiothoracic Surgery, Fortis Hospital, Mohali, India.
authors.forename: Rahat
authors.initials: R
authors.lastname: Brar
authors.affiliation: Department of Cardiothoracic Surgery, Fortis Hospital, Mohali, India.
authors.forename: Tek Singh
authors.initials: TS
authors.lastname: Mahant
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000009:adverse effects* / Q000379:methods; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D009204:Myocardial Revascularization / Q000379:methods; D012501:Saphenous Vein / Q000637:transplantation*; D056346:Sternotomy / Q000009:adverse effects*; D013249:Sternum / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000293:injuries; D015898:Tomography Scanners, X-Ray Computed
keywords: Coronary artery bypass; Internal mammary-coronary artery anastomosis; Intraoperative complications; Sternum; off-pump