Emphysematous lung occupying the whole dome of the left pleural cavity and expanding well over the midline may occasionally present a significant problem for positioning of the left internal thoracic artery, although the graft has been mobilized up to its origin. To avoid an undue tension on it, we combined a well known technique of the pericardial incision with the pericardial strip technique, enabling the lung to expand freely.
LoopF.D., LytleB.W., CosgroveD.M., StewartR.W., GoormasticM., WilliamsG.W., GoldingL.A.R., GillC.C., TaylorP.C., SheldonW.C. and ProudfitW.L., Influence of the internal-mammary-artery graft on 10-year survival and other cardiac events. New England Journal of Medicine, 1986, 314, 1–6.
2.
LoopF.D., LytleB.W., CosgroveD.M., GoldingL.A.R., TaylorP.C. and StewartR.W., Free (aorta-coronary) internal mammary artery graft. Late results. Journal of Thoracic and Cardiovascular Surgery, 1986, 92, 827–831.
3.
CosgroveD.M. and LoopF.D., Techniques to maximize mammary artery length. Annals of Thoracic Surgery, 1985, 40, 78–79.
4.
ToddE.P., EarleG.E., JaggersR. and SekelaM., Pericardial flap to minimize internal mammary artery anastomotic tension. Annals of Thoracic Surgery, 1987, 44, 665–666.
5.
Rama RaoP.S., NatarajanK.M. and MorrrittG., ‘LIMA fissure’ for a tension-free IMA graft in emphysema. Annals of Thoracic Surgery, 1997, 63, 561–562.
