Situation

A patient who underwent CABG x 4 8 years ago is referred for a left mediasteinotomy. What do you do ?

 

Opinion

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Opinion

The question here was was the LIMA used. You can tell this from the CXR if the LIMA harvest was with clips, or from the CT scan as it will not be on the posterior of the left anterior aspect of the chest wall on the scans. The information needed from the CT scan is the exact relationship of the LIMA to the mass, if the LIMA is behind the mass then you can do a mediasteinotomy and just biopsy the front of the mass.