A new pattern for using both thoracic arteries to revascularize the entire heart: the pi-graft.
We present a complex graft for total arterial revascularization based on bilateral skeletonized internal thoracic arteries (ITA). The lower two-thirds of the free right ITA is anastomosed to the proximal segment of the left in situ ITA using the T-graft technique (Tector-Barner-Calafiore). The free, transected distal part of the left ITA is then anastomosed end-to-side on free right ITA (T-on-T anastomosis). In addition, the technique may use another graft extending the proximal third of the in situ right ITA with the free radial artery for right-sided revascularization. The entire operation can be performed off-pump to avoid any procedure on the ascending aorta.
Prapas
Sotirios N
SN
Department of Cardiac Surgery, Henry Dunant Hospital, Athens, Greece. sprapas@dunanthospi.gr
Anagnostopoulos
Constantine E
CE
Kotsis
Vassilios N
VN
Stavropoulos
George P
GP
Sidiropoulos
Alexis V
AV
Ananiadou
Olga G
OG
Palatianos
George M
GM
D000714:Anastomosis, Surgical / Q000379:methods; D003327:Coronary Disease / Q000601:surgery*; D006801:Humans; D009204:Myocardial Revascularization / Q000379:methods*; D013895:Thoracic Arteries / Q000601:surgery / Q000637:transplantation*; D014656:Vascular Surgical Procedures / Q000379:methods