HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Kaan Kirali Nihan Kayalar Tuncer Koçak Cevat Yakut Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kirali, K. Articles by Yakut, C. Search for Related Content PubMed PubMed Citation Articles by Kirali, K. Articles by Yakut, C. Related Collections Coronary disease Minimally invasive surgery

Eur J Cardiothorac Surg 2005;27:923-924
© 2005 Elsevier Science NL

How-to-do-it

Reversed-J inferior sternotomy for awake coronary bypass

Kaan Krali^a,*, Nihan Kayalar^a, Tuncer Koçak^b, Cevat Yakut^a

^a Department of Cardiovascular Surgery, Kouyolu Heart and Research Hospital, 34718 Kadköy, Istanbul, Turkey
^b Department of Cardiovascular Anesthesia, Kouyolu Heart and Research Hospital, Istanbul, Turkey

Received 13 September 2004; received in revised form 5 January 2005; accepted 17 January 2005.

^* Corresponding author. Tel.: +90 216 3266969; fax: +90 216 3390441. (E-mail: imkkirali{at}yahoo.com).

Many approaches for minimally invasive coronary bypass surgery are available and to further decrease the invasiveness, coronary artery bypass grafting has been performed under high thoracic epidural anesthesia without endotracheal intubation in the last years. Less invasive approach to coronary artery bypass graft operations is possible through combination of the high thoracic epidural anesthesia and a reversed-J sternotomy, and coronary revascularization can be accomplished without any additional technical difficulties and with a good exposure of both the left anterior descending artery and the left internal thoracic artery. This technique is less traumatic for patients and provides practical better oxygenation and shorter hospital stay.

Key Words: Thoracic epidural anesthesia • Awake coronary bypass • Skeletonized internal thoracic artery • Partial sternotomy • Reversed-J sternotomy