Do you need to clamp a patent left internal thoracic artery-left anterior descending graft in reoperative cardiac surgery?

Background: Dogma suggests optimal myocardial protection in cardiac surgery after prior coronary artery bypass graft surgery (CABG) with patent left internal thoracic artery (LITA) pedicle graft requires clamping the graft. However, we hypothesized that leaving a patent LITA-left anterior descending (LAD) graft unclamped would not affect mortality from reoperative cardiac surgery.

Methods: Data were collected on reoperative cardiac surgery patients with prior LITA-LAD grafts from July 1995 through June 2006 at our institution.

Cardiac injury during resternotomy does not affect perioperative mortality.

Background: Cardiac injury at the time of resternotomy is a complication faced by all cardiac surgeons, although little is known about its effects on morbidity and mortality. This study was designed to address these questions.

Study Design: Resternotomies performed at the University of Virginia from 1996 to 2005 were identified.