NEW TECHNIQUE "Right Anterior Small Thoracotomy (RAST operation) for grafting the Right Internal Thoracic Artery to the Posterior Descending Artery (RITA to PDA) on the beating heart in a third REDO CABG patient". A novel coronary technique.

Abstract

Third REDO-CABG is a challenge for the surgical team. Usually a patent mammary is the only graft working and the sternotomy becomes a risky procedure. Injury to a patent graft has been associated to a high mortality rate. Many different approaches have been proposed. We describe a novel technique to approach the right coronary artery through a right anterior small thoracotomy using the right mammary prolonged with saphenous vein for grafting the posterior descending artery on the beating heart. The technique is very simple and feasible because anatomically the right coronary artery and the right mammary are very close and the mobilization of the heart is minimal.

Right single lung transplant with off-pump coronary artery bypass grafting using in situ right internal thoracic artery via thoracotomy

“… 3 However, to the best of our knowledge, there has been only one report of CABG using the RITA through a right thoracotomy. 4 Guida and colleagues 4 reported third-time redo CABG using the RITA through a right thoracotomy. However, the RITA needed to be extended with a saphenous vein graft to reach the posterior descending artery.…”

Aortic valve replacement and coronary artery bypass grafting through a right thoracotomy for a patient with a left chest wall tumor

“…Although there are few reports of CABG via right thoracotomy, Guida et al 4 have reported a beating heart grafting technique through the right anterior small thoracotomy. Moreover, Mihos et al 5 have also reported simultaneous AVR and CABG for the right coronary artery via the right mini-thoracotomy approach.…”

“…Although there are few reports of CABG via right thoracotomy, Guida et al. 4 have reported a beating heart grafting technique through the right anterior small thoracotomy. Moreover, Mihos et al.…”