Nagasao T, Takayama M, Miyamoto J, Ding W, Jiang H
Plastic and Reconstructive Surgery, Keio University Hospital, Tokyo, Japan.
Thorac Cardiovasc Surg. 2011 Feb;59(1):34-9. doi: 10.1055/s-0030-1249922. Epub 2011 Jan 17.
To perform a minimally invasive repair for pectus excavatum safely, accurate knowledge of the anatomy of the retrosternal region is crucial. This study was carried out to provide more information on this region.
Thick vessels connecting the internal mammary vessels and anterosuperior phrenic vessels were present in a certain number of cadavers. This presence of a vascular communication was observed in 44 % of left thoracic cavities and 12.5 % of right thoracic cavities. The breaking strengths of the pericardium and diaphragm were found to be nearly ten times greater than that of the pleura.
Care should be taken not to injure vessels connecting the internal mammary vessels and anterosuperior phrenic vessels when performing retrosternal undermining of the xiphoid region. Since the pericardium is much thicker than the pleura, injury of the pericardium can be avoided by careful undermining.
