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Redo aortic valve surgery with endovascular control of the internal thoracic artery graft.

The Journal of heart valve disease 20(2):175 (2011) PMID 21560818

Redo aortic valve surgery (AVS) in patients with patent pedicled internal thoracic artery (ITA) grafts remains a challenging procedure because of the possibility of injury to the grafts and difficulties in optimal myocardial protection. This procedure is associated with a significant mortality and morbidity. Different approaches to myocardial protection and ITA graft dissection and control have been described. An intraoperative technique is proposed that provides endovascular control of the ITA graft, using an angioplasty balloon positioned during cross-clamping.