Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
 
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REVIEW ARTICLE
Year : 2014  |  Volume : 9  |  Issue : 3  |  Page : 138-143

Save or sacrifice the internal mammary pedicle during anterior mediastinotomy?


1 Department of Cardiothoracic Surgery, School of Medicine, University Hospital of Ioannina, 45500 Ioannina, Greece
2 Department of General Surgery, General Oncology Hospital of Kifi ssia "Agioi Anargyroi", 41 Kaliftaki Street, P.C. 14564, Kifissia, Athens, Greece

Correspondence Address:
Nikolaos A. Papakonstantinou
12 Zilon Street, Rizoupoli, 11142 Athens
Greece
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DOI: 10.4103/1817-1737.134067

PMID: 24987471

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Ligation and dissection of internal mammary vessels is the most under-estimated complication of anterior mediastinotomy. However, patients requiring anterior mediastinotomy may experience long survival that makes the development of ischemic heart disease throughout their life possible. Therefore, the un-judicial sacrifice of the internal mammary pedicle may deprive them from the benefit to have their internal mammary artery used as a graft in order to successfully bypass severe left anterior descending artery stenoses. We recommend the preservation of the internal mammary pedicle during anterior mediastinotomy, which should be a common message among our colleagues from the beginning of their training.


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