AnatomyDiseasesChemicals and DrugsAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPhenomena and ProcessesHealth Care
Mammary ArteriesInternal Mammary-Coronary Artery AnastomosisThoracic ArteriesArteriesSaphenous VeinCoronary Artery BypassRadial ArteryGraft Occlusion, VascularVascular PatencyPulmonary ArterySubclavian ArteryCarotid ArteriesSubclavian Steal SyndromeCerebral ArteriesRenal ArteryFemoral ArteryCoronary VesselsCoronary AngiographyMesenteric ArteriesCoronary DiseaseSternumBasilar ArteryVascular GraftingVasoconstrictionVasodilationMyocardial RevascularizationMuscle, Smooth, VascularEndothelium, VascularIliac ArteryVertebral ArteryCineangiographyTreatment OutcomeVasodilator AgentsCoronary Artery Bypass, Off-PumpSpasmOmentumEpigastric ArteriesVasoconstrictor AgentsCarotid Artery, InternalAngiographyDextrocardiaCoronary CirculationCarotid Artery DiseasesCoronary Artery DiseaseStentsSplenic ArteryBrachial ArteryAngina PectorisPostoperative ComplicationsArteriovenous AnastomosisHepatic ArteryCarotid Artery, CommonFollow-Up StudiesTherapeutic OcclusionSternotomyTime FactorsTissue and Organ HarvestingAneurysm, FalseTomography, X-Ray ComputedCeliac ArteryEndothelin-1NitroglycerinSurgical Procedures, Minimally InvasiveOphthalmic ArteryReoperationMesenteric Artery, SuperiorPapaverineRegional Blood FlowAngioplasty, BalloonRetrospective StudiesAcetylcholineUmbilical ArteriesCardiac CatheterizationMiddle Cerebral ArteryRenal Artery ObstructionAortaSitus InversusNitric OxideArteriosclerosisTemporal ArteriesBiological FactorsAngioplasty, Balloon, CoronaryBronchial ArteriesCoronary StenosisVascular Surgical ProceduresPopliteal ArteryUlnar ArteryPhenylephrine
CABGGraftsWound infectionThoracoacromial arteryRight internal mammarDeep inferior epigasInfectionDissectionSingle internal mammaryPosteriorBilateral internal thoracic arteriesAxillary arteryInferiorVeinExternal iliacBypass GraftingInternal mammary arterialArterialBranchesIntercostalGraftCarotidEpigastric ArteriesMusculophrenic arterySurgeryBranchSuperior epigastricInfectionsRevascularizationOsteomyelitisVesselsProcedureVertebralAnteriorMedian sternotomySurgicalFemoralHypertrophyFixationLeftThoracotomy
CABG10
  • Therefore, this prospective observational study aimed to evaluate whether pre- and perioperative changes in blood acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activity were associated with POD development in patients undergoing isolated elective coronary artery bypass graft (CABG) surgery. (bvsalud.org)
  • Skeletonization is an advanced technique of graft harvesting for coronary artery bypass grafting (CABG), and while it requires meticulous attention, it has many advantages. (figshare.com)
  • We performed a review of all median sternotomies performed between 5/1/2007-5/31/2013, identifying patients undergoing coronary artery bypass graft (CABG), valve, or aortic root procedures. (aaps1921.org)
  • In this study we reviewed the results of using INPWT for high risk patients with coronary artery bypass grafting (CABG) using bilateral internal mammary arteries. (bvsalud.org)
  • Coronary artery bypass grafting (CABG) involves bypassing native coronary arteries that have high-grade stenosis or occlusion not amenable to angioplasty with stent insertion. (msdmanuals.com)
  • Depending on the severity, number and location of the blockages, your cardiologist will determine (often in conjunction with the cardiac surgeon) whether medical management, balloon angioplasty and stenting, or coronary artery bypass grafting (CABG) is necessary. (pivotalhealthcarepartners.com)
  • CABG is an operation involving a median sternotomy, exposing the heart, placing the patient on a heart-lung machine (or occasionally left beating, known as off-pump), and using the internal mammary artery, the greater saphenous vein and/or the radial artery to bypass the blockages in the coronary arteries. (pivotalhealthcarepartners.com)
  • The use of coronary artery bypass grafting (CABG) supported by cardiopulmonary bypass (CPB) evolved into a practical technique during the late 1960s and has since then been the state of the art with low morbidity and mortality. (medicus.ru)
  • Coronary artery bypass grafting (CABG) remains the most common cardiac surgery performed today worldwide. (amegroups.org)
  • Coronary artery bypass grafting (CABG) is still the most commonly performed cardiac surgery procedure worldwide, representing annual volumes of approximately 200,000 isolated cases ( 1 ) in the US and an average incidence rate of 62 per 100,000 inhabitants in western European countries ( 2 , 3 ). (amegroups.org)
Grafts6
  • The risk profile increases if the patient is diabetic, has COPD, is overweight, is undergoing repeat cardiac surgery, is taking steroid medication, has underlying osteoporosis, is likely to have a prolonged procedure, or requires bilateral internal mammary artery grafts, etc. (utmbhealth.com)
  • Off-pump coronary artery bypass grafting using skeletonized in situ arterial grafts. (figshare.com)
  • Routine use of bilateral internal thoracic artery grafts for left-sided myocardial revascularization in insulin-dependent diabetic patients: early and long-term outcomes. (raccv.com.ar)
  • Royse A, Pamment W, Pawanis Z, Clarke-Errey S, Eccleston D, Ajani A, Wilson W, Canty D and Royse C. Patency of conduits in patients who received internal mammary artery, radial artery and saphenous vein grafts. (edu.au)
  • Second, the modern coronary artery surgery has developed on the foundation of testing several grafts and an attempt to standardize them, which has brought along the beginning of evidence-based cardiac surgery. (amegroups.org)
  • Before grafts were routinely used for coronary surgeries, direct operation on the coronaries advanced again in 1961, when the Swedish surgeon Ake Senning enlarged the lumen of a left main coronary artery using a pericardial patch ( 11 ). (amegroups.org)
Wound infection9
  • Diabetes mellitus is a risk factor for deep sternal wound infection after open heart surgical procedures. (elsevierpure.com)
  • We previously showed that elevated postoperative blood glucose levels are a predictor of deep sternal wound infection in diabetic patients. (elsevierpure.com)
  • Therefore, we hypothesized that aggressive intravenous pharmacologic control of postoperative blood glucose levels would reduce the incidence of deep sternal wound infection. (elsevierpure.com)
  • Compared with subcutaneous insulin injections, continuous intravenous insulin infusion induced a significant reduction in perioperative blood glucose levels, which led to a significant reduction in the incidence of deep sternal wound infection in the continuous intravenous insulin infusion group (0.8% [12 of 1,499]) versus the intermittent subcutaneous insulin injection group (2.0% [19 of 968], p = 0.01 by the X 2 test). (elsevierpure.com)
  • relative risk, 2.0) increased the risk of deep sternal wound infection. (elsevierpure.com)
  • Coronary revascularization with bilateral internal mammary arteries is associated with increased long-term survival, but underutilized due to sternal wound infection concerns. (qxmd.com)
  • The risk of deep sternal wound infection (DSWI) following median sternotomy is associated with considerable morbidity and mortality. (aaps1921.org)
  • Ravaux JM, Guennaoui T, Mélot C, Schraverus P. Bilateral Internal Mammary Artery Bypass Grafting: Sternal Wound Infection in High-Risk Population. (raccv.com.ar)
  • Patients and Methods: ninety-eight cardiac surgery patients operated via median sternotomy were included in the study and the role of patient related factors (age, gender, obesity and diabetes mellitus) in the incidence of postoperative superficial and deep sternal wound infection was accessed. (bvsalud.org)
Thoracoacromial artery1
  • It is a Mathis and Nahai type V muscle flap with the thoracoacromial artery as the major blood supply and intercostal perforators arising from the internal thoracic artery providing a segmental blood supply. (medscape.com)
Right internal mammar2
Deep inferior epigas4
  • This video depicts the microvascular anastomosis of the deep inferior epigastric artery and vein to the internal mammary artery and vein in an anterograde fashion for a delayed bilateral deep inferior epigastric perforator (DIEP) flap reconstruction in a 53-year-old female patient status post bilateral mastectomy for breast cancer. (csurgeries.com)
  • Background The purpose of this study was to compare the anatomical features of the internal mammary vessels (IMVs) at the second and third intercostal spaces (ICSs) with regard to their use as recipient vessels in deep inferior epigastric artery perforator (DIEP) flap breast re-construction. (ewha.ac.kr)
  • Results CT angiographic analysis revealed the mean diameter of the deep inferior epigastric artery to be 2.42±0.27 mm, while that of the deep inferior epigastric vein was 2.91±0.30 mm. (ewha.ac.kr)
  • The superior epigastric artery afterwards creates branches inside the rectus abdominis muscle and creating choke anastomoses or often a true arterial attachment on or around the level of the midpoint among the xiphisternum and umbilicus , proceeds caudally to connect with an equivalent member of the deep inferior epigastric artery. (earthslab.com)
Infection2
  • Should Sternal Infection Scare Us? (raccv.com.ar)
  • You will be given detailed instructions upon discharge concerning diet, medications, incision care, sternal precautions, signs and symptoms of an infection or other potential problems, and activity level. (pivotalhealthcarepartners.com)
Dissection4
  • The Rultract® retractor is commonly used in IMA Dissection, Sternal Elevation for Modified Nuss Pectus Repair, Adult and Pediatric Resternotomy, and Panniculectomy. (rultract.com)
  • The dissection should be continued until the artery is completely freed from the parasternal tissues to the level of the bifurcation. (figshare.com)
  • After abdominal flap dissection and recipient internal mammary vessel harvest, the contralateral abdominal DIEP flaps are anastomosed with recipient vessels and nerves. (csurgeries.com)
  • A 52 year old male smoker undergoing coronary artery bypass grafting for three vessel coronary artery disease and moderately impaired left ventricular function was felt to have a mass arising from the under surface of right costal margin adjacent to right lower sternal margin while sternopericardial ligament was being broken off by finger dissection prior to sternotomy. (biomedcentral.com)
Single internal mammary1
  • Our institution used only single internal mammary arterial grafting in the year prior to implementing a dedicated bilateral grafting program using skeletonized technique. (qxmd.com)
Posterior3
  • In addition to the veins by the union of which it is formed, the right innominate vein receives the right vertebral and internal mammary veins, the first right posterior intercostal vein, and sometimes the right inferior thyreoid vein. (co.ma)
  • We report the case of a 60-year old woman with three posterior mediastinal bronchial artery aneurysms who presented with unilateral periscapular pain, shortness of breath, hoarseness, and dysphagia. (authorea.com)
  • The superior epigastric artery goes into the medial posterior side of the rectus abdominis muscle and also passes through the posterior rectus sheath at the back of the seventh costal cartilage. (earthslab.com)
Bilateral internal thoracic arteries2
Axillary artery2
  • Pectoralis minor crosses in front of axillary artery and divides it into three parts . (medicoapps.org)
  • For example, the left subclavian artery becomes the axillary artery as it passes through the body wall and into the axillary region, and then becomes the brachial artery as it flows from the axillary region into the upper arm (or brachium). (cuny.edu)
Inferior6
  • inferior a lo descrito en otras investigaciones. (raccv.com.ar)
  • Venous anastomosis between the deep inferior epigastric (DIE) vein and internal mammary vein was facilitated through use of a venous coupler. (csurgeries.com)
  • At the same time a section of external iliac artery, the inferior epigastric artery , by coming in front of the arcuate line moves in the sheath. (earthslab.com)
  • This perforator bears no resemblance to the superficial inferior epigastric artery and is created by the deep system. (earthslab.com)
  • The superior epigastric artery gives lateral as well as medial branches and also it anastomoses around 4 cm above the umbilicus along with sections of the inferior epigastric artery. (earthslab.com)
  • Inferior epigastric arteries. (earthslab.com)
Vein6
  • With the left chest wall elevated and the parietal pleura and pericardium dissected free, the course of the internal mammary artery and vein can be identified clearly. (figshare.com)
  • A parallel cut is made in the inner chest wall fascia about 5 mm medial to the visualized mammary vein. (figshare.com)
  • When the under-surface of the vein is clearly exposed, the artery subsequently becomes visible. (figshare.com)
  • Proximally, the mammary vein may be clipped and divided, clearing the view for the artery. (figshare.com)
  • Materials and Methods: Pre-pectoral tissue expanders were removed with a total capsulectomy, and the internal mammary vein and artery were exposed after pectoral division and cartilaginous 3rd rib removal. (csurgeries.com)
  • Like a street that changes name as it passes through an intersection, an artery or vein can change names as it passes an anatomical landmark. (cuny.edu)
External iliac1
  • It can also be used for controlling the distal external iliac artery during aorto-bi-drmoral bypass procedures, femoral-popliteal reconstruction, profundaplasties, or femoral embolectromies. (kappsurgical.com)
Bypass Grafting8
Internal mammary arterial1
  • Results: Bilateral abdominal DIEP flaps were anastomosed to the contralateral internal mammary arterial and venous counterparts. (csurgeries.com)
Arterial1
  • Arterial anastomosis between the DIE artery and internal mammary artery was achieved through handsewn, simple interrupted sutures. (csurgeries.com)
Branches3
  • The authors prefer dissecting using an electric cautery rather than sweeping the pleura with a gauze because this may damage the small branches of the mammary vessels and cause some bleeding, making it more difficult to expose the artery. (figshare.com)
  • The tributaries of the internal mammary veins are (a) The venæ comites of the superior epigastric and musculo-phrenic arteries, which in their turn receive tributaries which correspond with the branches of the arteries they accompany. (co.ma)
  • The three main coronary arteries and their branches course along the surface of the heart providing blood to the heart muscle. (pivotalhealthcarepartners.com)
Intercostal1
  • The first intercostal branch of the internal mammary artery must be identified and divided to avoid any possible steal phenomenon from the internal mammary flow. (figshare.com)
Graft5
  • For example, skeletonization of the IMA can minimize sternal ischemia and lower the risk of mediastinitis, and the graft is longer and larger than a pedicled IMA. (figshare.com)
  • Cardiac surgery has become increasingly less invasive with advancements in surgical instruments and techniques, such as minimal invasive direct coronary artery bypass (MIDCAB) graft surgery and anterior thoracotomy for valve surgery [ 9 ]. (ekja.org)
  • The left internal mammary artery is typically used as a pedicled graft to the left anterior descending coronary artery. (msdmanuals.com)
  • We have previously presented a method for performing coronary artery bypass graft operation on the beating heart without cardiopulmonary bypass (CPB). (medicus.ru)
  • coronary artery bypass graft operation has been shown to be a safe and feasible procedure with the potential benefits of reduced operative bleeding and myocardial damage without prolonging intraoperative support or total operating time. (medicus.ru)
Carotid1
Epigastric Arteries1
Musculophrenic artery1
  • The internal mammary artery (A.k.a Internal thoracic artery ) generates the superior epigastric artery along with the musculophrenic artery by dividing below the costal cartilage of the sixth rib. (earthslab.com)
Surgery6
  • A study by the Department of Surgery, Section of Plastic Surgery, University of Chicago suggests that sternal plating helps to reduce complications, infections and helps speed recovery time. (utmbhealth.com)
  • Royse AG, El-Ansary D, Hoang W, Lui E, McCusker M, Tivendale L, Yang Y, Canty DJ and Royse CF. A randomized trial comparing the effects of sternal band and plate fixation of the sternum with that of figure-of-8 wires on sternal edge motion and quality of recovery after cardiac surgery. (edu.au)
  • However, until this point in time, the main obstacle to the evolution of coronary surgery was the inability to picture the coronary arteries. (amegroups.org)
  • Annual Report for 2018 by the Japanese Association for Coronary Artery Surgery (JACAS). (tmd.ac.jp)
  • The Use of Intraoperative Transit Time Flow Measurement for Coronary Artery Bypass Surgery: Systematic Review of the Evidence and Expert Opinion Statements. (tmd.ac.jp)
  • The large Adult Renal Clamp (Angled Clamp) is designed to control the common iliac artery, the external of internal iliac arteries during surgery for abdominal aortic aneurysmectomy of for aorto-iliac occlusive disease. (kappsurgical.com)
Branch1
Superior epigastric3
  • The superior epigastric artery emerges around the sixth or seventh costal cartilage and is a section of internal thoracic artery . (earthslab.com)
  • The superior epigastric artery by entering the gap between the costal and xiphoid slips at the start of the diaphragm goes inside the rectus and also enters deep to the rectus abdominis . (earthslab.com)
  • The first large perforator that is often referred to as the superficial superior epigastric arter y is oftentimes produced by this artery at the costal margin. (earthslab.com)
Infections4
  • The reported incidence of sternal infections ranges from 0.9 to 20%, and the incidence of mediastinitis is 1-2% in most studies. (bvsalud.org)
  • Several studies have examined and identified possible causes and risk factors associated with sternal infections. (bvsalud.org)
  • Results: The results related to sternal wound infections were similarly attributed to the conventional group (10.9%) and the INPWT group (10.2%) (P=1.00). (bvsalud.org)
  • Also, wound infections occasionally cause mediastinitis or sternal osteomyelitis, which can be difficult to treat. (msdmanuals.com)
Revascularization1
  • Current trends in bilateral internal thoracic artery use for coronary revascularization: Extending benefit to high-risk patients. (raccv.com.ar)
Osteomyelitis1
  • Some believe that the process begins as an isolated area of sternal osteomyelitis that eventually leads to sternal separation. (medscape.com)
Vessels3
  • likewise, using the internal mammary vessels for a free TRAM flap procedure arguably is a refinement of the traditional use of the thoracodorsal vessels. (medscape.com)
  • These CVT Surgical Clamps are ideally suited for clamping of arteries located in the depths and superficial vessels of the surgical field. (kappsurgical.com)
  • As you learn about the vessels of the systemic and pulmonary circuits, notice that many arteries and veins share the same names, parallel one another throughout the body, and are very similar on the right and left sides of the body. (cuny.edu)
Procedure2
  • Introduction: In adult congenital patients with transposition of the great arteries originally treated with the Mustard (atrial switch) procedure, the most common reason for re-intervention is baffle stenosis. (authorea.com)
  • Versatile components are easily positioned of removed from the sternal retractor during any portion of the procedure Universally adjustable retractor blades accommodate any anatomical situation for greater visualization while reducing the need for surgical assistance For excellent and consistent heart valve exposure, the RosenkranzTM Pediatric Open Heart Retractor set the standard for pediatric and small child use. (kappsurgical.com)
Vertebral1
  • The manubrium is located at the level of the T3 and T4 vertebral bodies and is the widest and thickest of the 3 sternal bones. (medscape.com)
Anterior3
  • The central anterior chest is defined by the sternum, which consists of 3 separate bones of the manubrium, sternal body, and xiphoid process. (medscape.com)
  • The underlying method of this improvement was the development of collateral circulation to the left anterior descending (LAD) artery, which has recently been demonstrated with angiography to support cardiac function 30-years postoperatively ( 8 ). (amegroups.org)
  • While moving across the diaphragm in the space between the costal as well as the sternal parts of the muscle, it declines to the anterior abdominal wall . (earthslab.com)
Median sternotomy1
  • Operative characteristics including internal mammary (IMA) harvest, re-operative median sternotomy, and concurrent procedures were identified. (aaps1921.org)
Surgical3
Femoral1
  • For example, you will find a pair of femoral arteries and a pair of femoral veins, with one vessel on each side of the body. (cuny.edu)
Hypertrophy1
  • Nonetheless, it is statistically rare for a young woman to experience virginal mammary hypertrophy that results in massive, oversized breasts, and recurrent breast hypertrophy. (wikipedia.org)
Fixation1
  • Nagaoka E, Arai H. Mechanical simulation study of reapproximated sternum rigidity comparing sternal fixation devices. (tmd.ac.jp)
Left5
  • This video shows the basic technique of skeletonized left internal mammary artery (LIMA) harvesting. (figshare.com)
  • It partly overlaps the innominate artery, which lies to its left side, and it is in front of the internal mammary artery, the right vagus nerve, and the upper end of the right pleural sac. (co.ma)
  • Arthur Vineberg further improved this concept in 1946 when he implanted the left internal thoracic artery (LITA) directly into the front wall of the left ventricle ( 6 ). (amegroups.org)
  • Left subclavian artery and right subclavian artery. (earthslab.com)
  • For example, the celiac trunk gives rise to the left gastric, common hepatic, and splenic arteries. (cuny.edu)
Thoracotomy1
  • The bronchial artery aneurysms were removed successfully via thoracotomy, with excellent recovery and relief of the periscapular pain. (authorea.com)