An Alternative Approach to Isolated Circumflex Coronary Bypass Reoperations

Cheung, David; Flemma, Robert J.; Mullen, Donald C.; Lepley, Derward

doi:10.1016/s0003-4975(10)61931-5

Cited by 32 publications

(10 citation statements)

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“…Also, it is observed in the review of the literature that the operative technique has varied a lot. The majority of the groups have been using some type of extracorporeal circulation with the femoro-femoral bypass being the most used [2][3][4][5][6][7][8][9][10]. Some groups have been using hypothermia and ventricular fibrillation to make the anastomoses [2,4].…”

Section: Discussionmentioning

confidence: 99%

“…The majority of the groups have been using some type of extracorporeal circulation with the femoro-femoral bypass being the most used [2][3][4][5][6][7][8][9][10]. Some groups have been using hypothermia and ventricular fibrillation to make the anastomoses [2,4]. The growing familiarity with the off-pump coronary artery bypass grafting technique has showed that there in no need for perfusional support [12,14,15].…”

Section: Discussionmentioning

confidence: 99%

“…Although the outcomes of reoperative coronary artery bypass grafting have been improved along the years [1], some clinical situations, such as the internal thoracic artery grafts, carry a higher risk during resternotomy. In 1982, Cheung et al; [2] and Faro et al [3] independently described the experience in performing left thoracotomy for circumflex coronary artery revascularization in patients who had undergone previous cardiac surgery. The use of left thoracotomy for myocardial revascularization, besides to have been proven as a simple technique, has been sporadically reported [4][5][6][7][8][9][10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Toracotomia esquerda para reoperação de revascularização miocárdica

Duarte¹,

Neto²,

Moraes³

2007

Rev Bras Cir Cardiovasc

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Toracotomia esquerda para reoperação de revascularização miocárdica

Duarte¹,

Neto²,

Moraes³

2007

Rev Bras Cir Cardiovasc

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“…prior mediastinitis, irradiation) or sternal wound complications, or severe adhesion of the anterior mediastinum determined by chest X-ray, CT, or surgical record, which may cause catastrophic hemorrhaging from damage to one of the cardiac chambers at the time of sternal re-entry. [4][5][6][7][8][9] 4) Calcified ascending aorta necessitating the avoidance of cross-clamping, since off-pump LCX grafting is impossible through median approach, and also the ascending aorta can be avoided as a proximal anastomotic site through left thoracotomy approach." 5) No touch to old atherosclerotic but patent SVGs is possible.…”

Section: Discussionmentioning

confidence: 99%

Reoperative coronary artery bypass via left thoracotomy

Ide

Fujiki

Nonaka

et al. 2000

Jpn J Thorac Caridovasc Surg

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The patient was a 49-year-old woman. When she was 39 years old, she underwent coronary artery bypass grafting (left internal thoracic artery to left anterior descending artery, saphenous vein graft to first diagonal branch). At the age 48, she had effort angina. On coronary angiography, triple-vessel disease was found, and she was treated conservatively. Progression of the disease was confirmed with detection of the left circumflex artery associated with jeopardized collateral to the right coronary artery showing total occlusion. The patient underwent reoperation. Since the left internal thoracic artery was patent despite occlusion of the saphenous vein graft, the approach of left thoracotomy was employed. Under cardiopulmonary bypass with ventricular fibrillation and left vent through left atrial appendage, the right radial artery was anastomosed to the left circumflex artery from the descending thoracic aorta, and the right gastroepiploic artery was anastomosed to the right coronary artery (4AV branch). Patency of the bypass was confirmed postoperatively. We consider this operative technique was especially useful for reoperation in cases of a patent internal thoracic artery in which left thoracotomy can be conducted safely.

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“…Reoperative CABG via a left thoracotomy (RCLT) has become a useful approach for patients requiring isolated revascularization of the circumflex coronary artery territory, and who are at high risk for a conventional approach 3–13 . The number of patients in previous reports is small and the long‐term follow‐up data after these operations are scarce.…”

mentioning

confidence: 99%