Computed tomographic angiogram of the chest (for redo sternotomy)

CTA of the chest in a patient with an LVAD scheduled to undergo explantation of the LVAD and heart transplantation via repeat median sternotomy. The CTA provided detailed information in the location of the LVAD and the outflow graft (labeled O) that was immediately adjacent to posterior surface of the sternum. For that reason, right femoral venous and left femoral arterial cannulae for CPB were placed prior to repeat sternotomy. Peripheral CPB with "sucker bypass" was initiated when the outflow graft (labeled O) was damaged during repeat sternotomy. The patient was cooled to 25°C on CPB to permit a brief period of deep hypothermic circulatory arrest to surgically clamp the outflow graft (labeled O) in order to restore CPB for the remainder of the operation.