title: Save or sacrifice the internal mammary pedicle during anterior mediastinotomy?
abstract: Ligation and dissection of internal mammary vessels is the most under-estimated complication of anterior mediastinotomy. However, patients requiring anterior mediastinotomy may experience long survival that makes the development of ischemic heart disease throughout their life possible. Therefore, the un-judicial sacrifice of the internal mammary pedicle may deprive them from the benefit to have their internal mammary artery used as a graft in order to successfully bypass severe left anterior descending artery stenoses. We recommend the preservation of the internal mammary pedicle during anterior mediastinotomy, which should be a common message among our colleagues from the beginning of their training.
authors.affiliation: Department of Cardiothoracic Surgery, School of Medicine, University Hospital of Ioannina, 45500 Ioannina, Greece.
authors.forename: Efstratios
authors.initials: E
authors.lastname: Apostolakis
authors.affiliation: Department of General Surgery, General Oncology Hospital of Kifissia "Agioi Anargyroi", 41 Kaliftaki Street, P.C. 14564, Kifissia, Athens, Greece.
authors.forename: Nikolaos A
authors.initials: NA
authors.lastname: Papakonstantinou
authors.affiliation: Department of Cardiothoracic Surgery, School of Medicine, University Hospital of Ioannina, 45500 Ioannina, Greece.
authors.forename: Serafeim
authors.initials: S
authors.lastname: Chlapoutakis
authors.affiliation: Department of Cardiothoracic Surgery, School of Medicine, University Hospital of Ioannina, 45500 Ioannina, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Prokakis
keywords: Anterior mediastinotomy; coronary artery disease; internal mammary artery graft; lung cancer; mediastinal tumors