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Does wrapping of the right internal thoracic artery to the left anterior descending artery always protect?

^a Department of Cardiac Surgery, Großhadern Medical Center, Marchioninistr. 15, Munich 81377, Germany
^b Institute for Diagnostic Radiology of the Ludwig-Maximilians-University Munich, Großhadern Medical Center, Marchioninistr. 15, 81377 Munich, Germany

^* Corresponding author. Address: Klinik und Poliklinik für Herzchirurgie, Klinikum Großhadern der Ludwig-Maximilians-Universität Mänchen, Marchioninistr. 15, Munich 81377, Germany. Tel.: +49-89-7095-2358
cvicol{at}helios.med.uni-muenchen.de

We report about a 72-year-old woman with coronary artery disease. Surgical revascularization was performed using three grafts. One of them was the right internal thoracic artery (RITA) to left anterior descending. This graft was covered by a PRECLUDE^® IMA Sleeve. Wound healing was impaired and became to a chronic sternal osteomyelitis and mediastinitis. Thirty-three months after the primary operation, the PRECLUDE^® IMA Sleeve was explanted, the sternum was partially resected and the resulting cavity reconstructed with an omentum flap. During that operation, the RITA bypass was damaged. Interposition of a venous segment was necessary to reconstitute the graft.

Key Words: Internal thoracic artery; Wrapping; Expanded polytetrafluoroethylene; Redo

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				G. Gatti, A. Pappalardo, L. Gon, and B. Zingone Protecting the Crossover Right Internal Thoracic Artery Bypass Graft With a Pedicled Thymus Flap Ann. Thorac. Surg., November 1, 2006; 82(5): 1919 - 1921. [Abstract] [Full Text] [PDF]