Exclusive Y graft operation for multivessel coronary revascularization.
BACKGROUND
The pedicled (in-situ) left internal mammary artery grafted to the left anterior descending artery has a very high late patency and reduces late mortality following coronary artery bypass surgery. A technique is described which achieves total arterial revascularization in patients with multivessel coronary disease and which is also entirely pedicled.


METHODS
Using the left internal mammary artery and radial artery joined as a composite Y graft, all coronary territories may be grafted.


RESULTS
One in-hospital death from 464 patients (0.2%) occurred. Age (mean +/- standard error) was 64.7 +/- 0.5 years and number of distal anastomoses 3.4 +/- 0.04. Of 1,681 patients from Royal Melbourne Hospital, 346 had this operation. Comparison found no preoperative selection bias and no postoperative differences in complications. Actuarial survival was 0.98 +/- 0.01 at 36.1 +/- 0.3 months.


CONCLUSIONS
Total arterial revascularization may be performed using the left internal mammary artery and radial artery as a composite Y graft. There was no increase in complications. This technique preserves the left internal mammary artery to left anterior descending artery graft.
Royse
A G
AG
Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia. alistair.royse@nwhcn.org.au
Royse
C F
CF
Raman
J S
JS
D000206:Actuarial Analysis; D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011446:Prospective Studies; D017534:Radial Artery / Q000637:transplantation*; D015996:Survival Rate; D016896:Treatment Outcome; D014739:Victoria