title: How to tailor A "pi" graft for complex myocardial revascularization: a variant of the mammary loop technique.
abstract: We present a new pattern for tailoring the "pi" graft that uses the advantages of the mammary loop technique. The two internal thoracic mammary arteries are skeletonized. The free right mammary artery is anastomosed end-to-side to the proximal part of the in situ left mammary artery to make a "Y" graft. The distal end of the left mammary artery is anastomosed end-to-side to the middle portion of the right one to form a loop with the two arteries. The loop is severed at the appropriate level at the time of the coronary anastomosis to form a "pi" graft. This technique allows a more rational use of the length of the two mammary arteries, because the branch leading to the left anterior descending artery is measured and cut precisely at the time of the anastomosis.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hôpital Jean Minjoz, Besançon, France. l.stoica@voila.fr
authors.forename: Lucian
authors.initials: L
authors.lastname: Stoica
authors.forename: Sidney
authors.initials: S
authors.lastname: Chocron
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Falcoz
authors.forename: Djamel
authors.initials: D
authors.lastname: Kaili
authors.forename: Joseph-Philippe
authors.initials: JP
authors.lastname: Etievent
mesh_terms: D003324:Coronary Artery Disease / Q000601:surgery*; D006801:Humans; D008323:Mammary Arteries / Q000601:surgery*; D009204:Myocardial Revascularization / Q000379:methods*; D014656:Vascular Surgical Procedures / Q000379:methods