Simple Techniques to Manage the Patent Internal Mammary Artery in Redo Cardiac Surgery

The presence of a patent internal mammary artery (IMA) represents a well-known technical challenge in redo cardiac surgery. Dissection of the IMA and controlling its flow during cardioplegic delivery has thus been considered essential steps. This maneuver however, is associated with the risk of damaging the IMA. Herein, we report a technique, which involves no attempts to dissect, or clamp the IMA in 44 consecutive redo cardiac surgery procedures. The results demonstrate that this technique is simple, safe, and reduces the chance of IMA injury.