Dissection of the two internal mammary arteries with maximal exposure and minimal adverse sequelae by means of an inexpensive, simple, atraumatic retractor.

Abstract

The increasing use of internal mammary arteries for grafting, the possibility that both internal mammary arteries should be used, and the need for longer portions of these vessels should multiple sequential distal anastomoses be needed make a technique for safe and extensive dissection of these vessels important. We describe such a technique that uses a retractor adapter. This adaptation has considerably reduced our reluctance to use both mammary arteries and to dissect lengths that can be used for multiple distal anastomoses. It has also reduced the prevalence of undesirable side effects from retraction.