{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T12:12:19Z","timestamp":1777551139351,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2018,1,24]],"date-time":"2018-01-24T00:00:00Z","timestamp":1516752000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Asian Cardiovasc Thorac Ann"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Procurement of the internal thoracic artery risks ipsilateral phrenic nerve injury and elevated hemidiaphragm. Anatomical variations increase the risk on the right side. Patients receiving left-sided in-situ right internal thoracic artery configurations appear to be at greatest risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From 2014 to 2016, 432 patients undergoing left-sided in-situ bilateral internal thoracic artery grafting were grouped according to right internal thoracic artery configuration: retroaortic via transverse sinus (77%) or ante-aortic (23%); targets were the circumflex and left anterior descending artery territories, respectively. Elevated hemidiaphragm was assessed by serial chest radiographs and categorized by side, complete (\u22652 intercostal spaces) versus partial, and permanent versus transient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Right elevated hemidiaphragm occurred in 4.2% of patients. The incidence of radiological complete right elevated hemidiaphragm was 2.8% (12\/432); 8 cases were transient with recovery in 3.5\u2009\u00b1\u20090.3 weeks. Permanent right elevated hemidiaphragm occurred in 0.9% (retroaortic group only). Permanent left elevated hemidiaphragm occurred in 0.9% and was significantly higher in the ante-aortic group (3\/99 vs. 1\/333, p\u2009=\u20090.039). No bilateral hemidiaphragm elevation was documented. Partial right elevated hemidiaphragm occurred in 1.4% and was not associated with adverse early or late respiratory outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite susceptible right phrenic nerve-internal thoracic artery anatomy, the incidence of permanent right elevated hemidiaphragm is low and no higher than left-sided in prone bilateral internal thoracic artery subsets. This reflects skeletonized internal thoracic artery procurement. Although statistical significance was not achieved, a retroaortic right internal thoracic artery configuration may constitute a higher risk of right phrenic nerve injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0218492317754143","type":"journal-article","created":{"date-parts":[[2018,1,24]],"date-time":"2018-01-24T10:09:13Z","timestamp":1516788553000},"page":"94-100","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["In-situ left-sided bilateral internal thoracic artery: elevated hemidiaphragm"],"prefix":"10.1177","volume":"26","author":[{"given":"Oren","family":"Lev-Ran","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Soroka University Medical Center, Beer-Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Abrahamov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Soroka University Medical Center, Beer-Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Baram","sequence":"additional","affiliation":[{"name":"Department of Radiology, Soroka University Medical Center, Beer-Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menachem","family":"Matsa","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Soroka University Medical Center, Beer-Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaron","family":"Ishai","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Soroka University Medical Center, Beer-Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ohad","family":"Gabai","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Soroka University Medical Center, Beer-Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yael","family":"Refaely","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Soroka University Medical Center, Beer-Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmud","family":"Abu Salah","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Soroka University Medical Center, Beer-Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gideon","family":"Sahar","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Soroka University Medical Center, Beer-Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,1,24]]},"reference":[{"key":"bibr1-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.142.1.6975951"},{"key":"bibr2-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(91)91268-Z"},{"key":"bibr3-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(95)70291-1"},{"key":"bibr4-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1378\/chest.113.1.8"},{"key":"bibr5-0218492317754143","doi-asserted-by":"crossref","first-page":"II170","DOI":"10.1161\/01.CIR.72.1.170","volume":"72","author":"Cosgrove DM","year":"1985","journal-title":"Circulation"},{"key":"bibr6-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(91)91334-R"},{"key":"bibr7-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.05.098"},{"key":"bibr8-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(94)90764-1"},{"key":"bibr9-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00511-3"},{"key":"bibr10-0218492317754143","first-page":"I11","volume":"98","author":"Buxton BF","year":"1998","journal-title":"Circulation"},{"key":"bibr11-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(97)00473-6"},{"key":"bibr12-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2004.07.059"},{"key":"bibr13-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(95)01171-4"},{"key":"bibr14-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1177\/0218492315573360"},{"key":"bibr15-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)02921-6"},{"key":"bibr16-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1378\/chest.98.3.661"},{"key":"bibr17-0218492317754143","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200012000-00010"}],"container-title":["Asian Cardiovascular and Thoracic Annals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0218492317754143","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0218492317754143","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0218492317754143","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T17:53:26Z","timestamp":1777398806000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0218492317754143"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,24]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1177\/0218492317754143"],"URL":"https:\/\/doi.org\/10.1177\/0218492317754143","relation":{},"ISSN":["0218-4923","1816-5370"],"issn-type":[{"value":"0218-4923","type":"print"},{"value":"1816-5370","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,24]]}}}