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A Minimally Invasive Alternative Approach for Reoperative Grafting of the Right Coronary Artery
Author(s) -
Abraham Reginald,
Ricci Marco,
Salerno Tomas,
Kerr Paul
Publication year - 2001
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2001.tb01142.x
Subject(s) - medicine , surgery , revascularization , sternum , cardiology , extracorporeal circulation , artery , bypass grafting , mammary artery , myocardial infarction
A bstract Background : Target vessel revascularization on a beating heart via a mini subxiphoid incision, not only eliminates the hazards of sternal reentry, but also avoids the detrimental systemic effects of extracorporeal circulation. Aim : The goal of the study was to develop and describe a safe and effective method to revascularize the right coronary artery in reoperative cases, using beating heart and minimally invasive techniques in lieu of the RGEA. Methods : There were three men and four women with a mean age of 69 years; four were second time reoperations and three third time reoperations. Through a subxiphoid approach, a lower ministernotomy is performed. Once the coronary target is established, a Rultract retractor is used to gently elevate the right half of the sternum to take down the RITA. A mechanical stabilizer was used to provide stabilization for distal anastamoses. Flow was measured in all the grafts with the Medi‐Stim before and after protamine administration. Results: Conclusion : We believe that this technique provides another effective approach to the patient who requires reoperative coronary revascularization of the RCA.