Abstract
In this case report we describe how to recycle the Left Internal
Thoracic Artery (LITA) when misused but not damaged. 8 years after a
Left Anterior Small Thoracotomy followed by LAD stenting for STEMI in
1st post-operative day, a 67 years old woman had a NSTEMI with
angiographic evidence of intra-stent re-stenosis with a perfectly patent
LITA, harvested only from the 4th to the 6th intercostal space. During
redo surgery, LITA was harvested as a pedicle from the anastomosis to
the 4th intercostal space and primarily from the 1st to the 4th
intercostal space. Special attention was paid at the level of the 4th
intercostal space where the vessel was stuck to the sternum: a 15 blade
was used being scissors or cautery too dangerous. At the end of
harvesting, the LITA was full-length available for a new coronary
anastomosis on LAD, distal to the previous one.