Improved Method for Direct Coronary Grafting Without CPB via Anterolateral Small Thoracotomy Piet W Boonstra, MD, PhD, Jan G Grandjean, MD, Massimo A.

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Presentation transcript:

Improved Method for Direct Coronary Grafting Without CPB via Anterolateral Small Thoracotomy Piet W Boonstra, MD, PhD, Jan G Grandjean, MD, Massimo A Mariani, MD, PhD The Annals of Thoracic Surgery Volume 63, Issue 2, Pages 567-569 (February 1997) DOI: 10.1016/S0003-4975(96)01024-7

Fig. 1 The site of skin incision for the small thoracotomy (A = sternal notch; B = lowest point of the left part on the chest; C = medial edge of the incision; LAD = left anterior descending coronary artery; LIMA = left internal mammary artery; RIMA = right internal mammary artery.) The Annals of Thoracic Surgery 1997 63, 567-569DOI: (10.1016/S0003-4975(96)01024-7)

Fig. 2 The specially adapted wound spreader (IMA Retractor) in site. The asymmetric direction of the spreading forces applied to the ribs creates a visual tunnel that permits optimal visualization of the left internal mammary artery (LIMA). The superior part of the arms further spreads the skin and the underlying soft tissues, thus enhancing the surgeon’s view. The Annals of Thoracic Surgery 1997 63, 567-569DOI: (10.1016/S0003-4975(96)01024-7)

Fig. 3 The coronary stabilizer (Access Platform and Stabilizer). The left anterior descending coronary artery is shown between the tines of the “horse-shoe,” which is made for pushing downward the epicardium. The Annals of Thoracic Surgery 1997 63, 567-569DOI: (10.1016/S0003-4975(96)01024-7)