Erschienen in:
01.04.2013 | COMMENTARY
Computed tomographic angiography prior to reoperative coronary artery bypass grafting: clinical benefit at the same cost
verfasst von:
Ronen Rubinshtein, David A. Halon, Basil S. Lewis
Erschienen in:
The International Journal of Cardiovascular Imaging
|
Ausgabe 4/2013
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Excerpt
Reoperative coronary artery bypass grafting (CABG) carries a not insignificant morbidity and mortality [
1] and requires an experienced surgeon using careful surgical techniques [
2] to allow safe exposure of thoracic structures. Preoperative assessment of thoracic anatomy may guide the surgeon to select techniques which minimize the risk, these related in part to adherence (or proximity) of the right ventricle (or grafts or aorta) to the sternum or bypass grafts crossing the midline near the sternum. Inadvertent dissection of these important structures may result in significant morbidity or even death. Alternative surgical techniques may include para-median sternotomy, peripheral cardiopulmonary bypass (prior to sternotomy), peripheral arterial/venous dissection (before sternotomy) or deep hypothermic circulatory arrest [
3]. …