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In situ bilateral skeletonized internal thoracic arterial grafting for left-side myocardial revascularization using an off-pump technique

^a Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City, 545-8585, Japan
^b Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan
^c Department of Cardiovascular Surgery, Shin-Tokyo Hospital, Chiba, Japan

*Corresponding author. Tel: +81-6-6645-3980; fax: +81-6-6646-3071.

E-mail address: tm-fukui{at}gem.hi-ho.ne.jp (T. Fukui).

The aim of this study was to review the clinical and angiographic outcomes of in situ skeletonized bilateral internal thoracic artery (ITA) grafting for left coronary arterial revascularization using an off-pump technique in 144 consecutive patients. We also assessed the difference between left and right ITA grafting to the left anterior descending coronary artery (LAD). Arrangement of the bilateral ITAs (grafting of the left/right ITA to the LAD) was decided according to the coronary anatomy and quality of the grafts. Early postoperative angiograms were evaluated in 110 patients. The average numbers of anastomoses and bilateral ITA anastomoses per patient were 3.4 and 2.3, respectively. There were no surgical deaths or sternal infection. The left and right ITA were anastomosed to the LAD in 106 (73.6%) and 38 (26.4%) patients, respectively. There were no differences in preoperative conditions and postoperative complications between the left ITA and right ITA to LAD groups. The patencies of the left and right ITAs were 99.1 and 100%, respectively. In situ skeletonized bilateral ITA grafting for left-side revascularization using an off-pump technique was shown to be feasible, producing excellent early clinical and angiographic outcomes. Furthermore, arrangement of bilateral ITAs did not affect outcomes.

Key Words: Coronary artery bypass grafts; Coronary artery bypass grafting; Off-pump coronary artery bypass grafting