title: Inverted T graft: novel technique using composite radial and internal thoracic arteries.
abstract: BACKGROUND
  Multiple arterial revascularization is feasible because of the excellent long-term patency of the arterial grafts compared with venous grafts. We present a new operative technique for multiple arterial revascularization using composite radial and internal thoracic arterial grafts.
  
  
  METHODS
  Between January and September 1997, 12 patients had coronary artery bypass grafting with inverted T graft. The indications for inverted T graft were aortic calcification in 4 patients, repeat coronary artery bypass grafting in 1 patient, and total arterial revascularization in 7 young patients. The inverted T graft was constructed by interconnecting the coronary arteries and radial artery with end-to-side and side-to-side anastomoses, and by anastomosing the internal thoracic artery to the side of radial artery.
  
  
  RESULTS
  Overall, 38 distal anastomoses (average number per patient, 3.2) were made with an inverted T graft. There were no deaths or perioperative myocardial infarctions. Postoperative angiography disclosed that all of the anastomoses were patent.
  
  
  CONCLUSIONS
  This technique allows multiple arterial revascularizations without technical difficulty. It is useful in patients with aortic calcification, repeat coronary artery bypass grafting patients, and young patients who are candidates for total arterial revascularization.
authors.affiliation: Department of Cardiovascular Surgery, University of Fukuoka School of Medicine, Japan. tashirot@msat.fukuoka-u.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Tashiro
authors.forename: K
authors.initials: K
authors.lastname: Nakamura
authors.forename: A
authors.initials: A
authors.lastname: Iwakuma
authors.forename: R
authors.initials: R
authors.lastname: Zaitu
authors.forename: H
authors.initials: H
authors.lastname: Iwahashi
authors.forename: A
authors.initials: A
authors.lastname: Murai
authors.forename: M
authors.initials: M
authors.lastname: Kimura
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000637:transplantation*; D013895:Thoracic Arteries / Q000637:transplantation*