XML Template (2014) [14.5.2014–12:02pm] //blrnas3/cenpro/ApplicationFiles/Journals/SAGE/3B2/AANJ/Vol00000/140101/APPFile/SG-AANJ140101.3d
(AAN)
[1–1] [PREPRINTER stage]
Images in Cardiothoracic Medicine and Surgery
Skeletonized gastroepiploic artery: How we do it
Asian Cardiovascular & Thoracic Annals 0(0) 1 ß The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492314535226 aan.sagepub.com
Alexander Weymann1,2, Naoki Minato2 and Takayuki Okada2
Figure 1. (A) A median thoracotomy is extended into the diaphragm, followed by opening of the abdominal cavity. (B, C) Vessel loops are passed under the gastroepiploic artery (arrow), followed by skeletonized harvesting using a Harmonic Scalpel. (D) The gastroepiploic artery is exposed throughout its entire length. After intravenous heparin application, diluted olprinone hydrochloride is injected into the gastroepiploic artery to avoid spasm and obtain a maximally dilated arterial conduit. (E) The gastroepiploic artery (arrow) is tunneled through a small incision in the diaphragm into the pericardial cavity. (F) The most common location of a gastroepiploic artery anastomosis is the distal right coronary artery; here, the atrioventricular branch of the right coronary artery (arrow).
The use of the gastroepiploic artery as a conduit for coronary artery bypass surgery has not been widely accepted due to unjustified reservations about the technical complexity, perioperative complications, and patency rate. As a result, even today, most patients with coronary artery disease do not receive complete arterial revascularization. Figure 1 illustrates the stages in our state-of-the-art harvesting technique for skeletonized gastroepiploic artery.
Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflict of interest statement None declared.
1
Department of Cardiothoracic Transplantation & Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, Harefield, UK 2 Department of Thoracic and Cardiovascular Surgery, Kansai Medical University, Osaka, Japan Corresponding author: Alexander Weymann, MD, Department of Cardiothoracic Transplantation & Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, Hill End Road, Harefield, Middlesex, UB9 6JH, UK. Email: [email protected]
Downloaded from aan.sagepub.com at Freie Universitaet Berlin on May 2, 2015
(AAN)
[1–1] [PREPRINTER stage]
Images in Cardiothoracic Medicine and Surgery
Skeletonized gastroepiploic artery: How we do it
Asian Cardiovascular & Thoracic Annals 0(0) 1 ß The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492314535226 aan.sagepub.com
Alexander Weymann1,2, Naoki Minato2 and Takayuki Okada2
Figure 1. (A) A median thoracotomy is extended into the diaphragm, followed by opening of the abdominal cavity. (B, C) Vessel loops are passed under the gastroepiploic artery (arrow), followed by skeletonized harvesting using a Harmonic Scalpel. (D) The gastroepiploic artery is exposed throughout its entire length. After intravenous heparin application, diluted olprinone hydrochloride is injected into the gastroepiploic artery to avoid spasm and obtain a maximally dilated arterial conduit. (E) The gastroepiploic artery (arrow) is tunneled through a small incision in the diaphragm into the pericardial cavity. (F) The most common location of a gastroepiploic artery anastomosis is the distal right coronary artery; here, the atrioventricular branch of the right coronary artery (arrow).
The use of the gastroepiploic artery as a conduit for coronary artery bypass surgery has not been widely accepted due to unjustified reservations about the technical complexity, perioperative complications, and patency rate. As a result, even today, most patients with coronary artery disease do not receive complete arterial revascularization. Figure 1 illustrates the stages in our state-of-the-art harvesting technique for skeletonized gastroepiploic artery.
Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflict of interest statement None declared.
1
Department of Cardiothoracic Transplantation & Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, Harefield, UK 2 Department of Thoracic and Cardiovascular Surgery, Kansai Medical University, Osaka, Japan Corresponding author: Alexander Weymann, MD, Department of Cardiothoracic Transplantation & Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, Hill End Road, Harefield, Middlesex, UB9 6JH, UK. Email: [email protected]
Downloaded from aan.sagepub.com at Freie Universitaet Berlin on May 2, 2015
