Right thoracotomy for reoperative right coronary artery bypass procedures.
The use of a right thoracotomy is a safe alternative approach for reentering the mediastinum for reoperative right coronary artery bypass grafting. This technique was used in 9 patients and allowed minimal dissection, reducing the risks of hemorrhage and injury to previously placed patent grafts. Cardiopulmonary bypass was used in 4 patients in whom myocardial protection was accomplished with systemic hypothermia. Right atrial cannulation provided adequate venous return, with arterial inflow established via the femoral artery (n = 2) or ascending aorta (n = 2). In 5 patients, revascularization was accomplished by temporary coronary artery occlusion without cardiopulmonary support. There were no deaths, and postoperative recovery was not delayed. Postoperative chest drainage (mean +/- standard deviation, 1,076 +/- 718 mL) was significantly less (p < 0.01) than redo median sternotomy (1,352 +/- 602 mL) in a similar population. Eight of 9 patients remain free of angina 29 +/- 24.8 months postoperatively.
Duke Scholars
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Related Subject Headings
- Thoracotomy
- Saphenous Vein
- Respiratory System
- Reoperation
- Middle Aged
- Male
- Humans
- Female
- Coronary Artery Bypass
- Constriction, Pathologic
Citation
Published In
DOI
ISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Thoracotomy
- Saphenous Vein
- Respiratory System
- Reoperation
- Middle Aged
- Male
- Humans
- Female
- Coronary Artery Bypass
- Constriction, Pathologic