Hiroshi Takami, MD, Taizo Hiraishi, MD, Tohru Kobayashi, MD

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Use of an Ultrasonic Surgical Aspirator to Expose Buried Coronary Arteries Hiroshi Takami, MD, Taizo Hiraishi, MD, Tohru Kobayashi, MD The Annals of Thoracic Surgery Volume 93, Issue 4, Pages 1326-1328 (April 2012) DOI: 10.1016/j.athoracsur.2011.11.017 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 The nodule tip of the ultrasonic surgical aspirator was applied to a beating heart immobilized by a vacuum-type mechanical stabilizer. Subepicardial fat tissue over the left anterior descending coronary artery was removed by the aspirator in off-pump coronary artery bypass grafting. The Annals of Thoracic Surgery 2012 93, 1326-1328DOI: (10.1016/j.athoracsur.2011.11.017) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Postoperative coronary angiograms years after the procedure. Arrows indicate the application sites of the ultrasonic surgical aspirator. (A) Left internal thoracic artery was grafted to left anterior descending artery, which was buried deep in fat tissue and exposed by an ultrasonic surgical aspirator 11 years previously. (B) The radial artery had been grafted to the intramyocardial obtuse marginal branch 8 years previously. The supraarterial myocardium over the artery was removed by the ultrasonic surgical aspirator for grafting. No deformity or calcification of coronary arteries was observed at the sites of aspirator application in these angiograms obtained years after the procedure. (LAD = left anterior descending artery, LITA = left internal thoracic artery, OM = obtuse marginal branch, RA = radial artery.) The Annals of Thoracic Surgery 2012 93, 1326-1328DOI: (10.1016/j.athoracsur.2011.11.017) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions