ANATOMIC BASES OF AORTOCORONARY BYPASSES - THE INTERNAL THORACIC ARTERY AND BLOOD-SUPPLY OF THE STERNUM

The internal thoracic a. is much used in cardiac surgery because of it s anatomic position, but its mobilisation may lead to devascularisatio n of the sternum. The aim of this study was to establish a precise sys tematisation of the vascularisation of the sternum by means of dissect ions and radiography after injection of contrast medium in 15 subjects . It is based on the internal thoracic a. and its collaterals, which f orm multiple anastomoses. This anatomic basis provides an understandin g of the problems of the devascularisation (partial and temporary) and the infections that may occur following the use of one or both intern al thoracic aa. during coronary bypass operations. However, it should always be regarded as the graft of choice, given the longevity of thes e bypasses.