V-composite grafting using the right internal thoracic artery grafts anastomosed to aorto-coronary bypass grafts

Abstract

V-composite grafting using the RITA and the A-C bypass graft provides excellent clinical outcomes with satisfactory early and 1-year patency rates.

Concomitant aorto-right subclavian artery bypass with off-pump coronary artery bypass grafting: a case report

“…Atherosclerotic stenosis of the subclavian artery or brachiocephalic trunk is sometimes associated with coronary artery disease [ 3 ]. Many patients with stenosis of the subclavian artery or brachiocephalic trunk are asymptomatic; however, the stenosis can cause stroke during CABG.…”

“…An 8-mm polytetrafluoroethylene graft was anastomosed to the right subclavian artery, and then the proximal end of this graft was anastomosed to the aorta with a side-biting clamp. Off-pump CABG was then performed using a method described previously [ 3 ]. The left internal thoracic artery and the free right internal thoracic artery were anastomosed to the left anterior descending artery and the left circumflex artery, respectively.…”

“…Proximal anastomoses between the saphenous vein grafts and the aorta were performed with proximal suturing devices. Lastly, a proximal anastomosis of the free right internal thoracic artery to the saphenous vein graft as a V-composite graft was performed [ 3 ].…”

A Technique to Make Multiple Proximal Anastomoses with One HEARTSTRING Suture Device

“…Although a Y‐composite graft can be made with the conventional HEARTSTRING technique, a V‐composite graft is preferrable because Y‐composite grafts of the free IMA from the SVG may lead to a steal phenomenon and/or a slit phenomenon. Nishigawa et al reported that a V‐composite graft suppresses the influence of the inflow conduit and improves the patency of the composite RIMA . Making a V‐composite graft is reasonable, and one HEARTSTRING system can easily make a V‐composite graft.…”

“…Nishigawa et al reported that a V-composite graft suppresses the influence of the inflow conduit and improves the patency of the composite RIMA. 2 Making a V-composite graft is reasonable, and one HEARTSTRING system can easily make a V-composite graft. This technique can also be applied to making V-composite grafts with multiple vein grafts, with or without a RIMA graft.…”