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| Name | How to harvest the left internal mammary artery (LIMA) : Part 1 |
| Video Uploader | Video From SBK (SBK) |
| Upload Date | This Video Uploaded At 22-02-2020 15:36:19 |
| Video Discription | The left internal mammary artery also called the LIMA or the LITA, is the gold standard conduit for myocardial revascularization because of its widely reported clinical and survival benefits when compared with saphenous vein grafts. The use of LIMA grafts increases survival and reduces the incidence of recurrent angina, late myocardial infarction, and repeat coronary interventions. The LIMA is the gold standard conduit for myocardial revascularization because of its widely reported clinical and survival benefits when compared with saphenous vein grafts. The use of LIMA grafts increases survival and reduces the incidence of recurrent angina, late myocardial infarction, and repeat coronary interventions. How to harvest: Techniques 1 Pedicled Conduit with fascia, muscle and fat Only conduit with accompanying veins 2 Pedicled but divided distally to start with (Hanging technique) With fascia, muscle and fat Without fascia, muscle and fat Clip Clip Cut : what is it?? Less tissue trauma, less postop drainage or bleeding Good and undamaged conduit Less postoperative complication Preserves collateral connections Avoid thermal injury to the IMA Anatomy: The IMA arises from the subclavian artery, above and behind the sternal end of the clavicle. In 70% of cases the LIMA originates alone, whereas in 30% it arises from a common trunk with other arteries like the thyrocervical trunk, suprascapular artery and the inferior thyroid artery. The artery descends vertically 1 cm to 2.3 cms lateral to the sternal border, behind the first six costal cartilages and is separated from the pleura at the second or third costal cartilage by a strong layer of endothoracic fascia and inferiorly by the transversus thoracis muscle. It is accompanied by two mammary veins, which ascend medially and laterally, respectively. The ITA ends as a bifurcation in 93% of the cases as the superior epigastric and musculophrenic arteries and as a trifurcation in 7% (a third branch, the Xiphoid / diaphragmatic branch adds to the previous ones) References: DOI:https://doi.org/10.1016/S0003-4975(96)00529-2 Full length article VOLUME 62, ISSUE 3, P908-909, AUGUST 01, 1996 https://mmcts.org/tutorial/611 Ann Thorac Surg 2015;100:1942–53 Hydrodissection of LIMA: Ann Thorac Surg 2005;80:355– 6 My Credentials: Facebook : https://www.facebook.com/The-Heart-Surgery-Factory-102326067972600/ Youtube : https://www.youtube.com/channel/UCAXvuk2YTOKcCUzCr2QatpA Gmail: [email protected] twitter: @theheartsurgeon |
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