Chest wall infarction following bilateral internal mammary harvesting
for coronary revascularization in a patient with previous aortic
abdominal aneurysm surgery: a rare complication.
Abstract
A 75 years old man with previous aortic abdominal aneurysm surgery
through a transverse laparotomy underwent bilateral internal mammary
artery (BIMA) to coronary artery bypass grafting (CABG). He immediately
thereafter developed a severe chest and upper abdominal walls ischemia
with metabolic acidosis, and finally deep sternum wound infection and
upper abdominal wall necrosis. He benefitted from sternal reconstruction
and vaccum assisted treatment, with delayed pectus major flap
reconstruction. Chest and abdominal wall infarction following BIMA
harvesting is a very rare but life-threatening complication. Caution use
of BIMA should be in order in patients with inferior epigastric artery
flow impairment.