[New technique to determine graft length using the proximal anastomotic system during off-pump coronary artery bypass grafting].
For determining the graft length for an aortic connector, grafts to the circumflex (Cx) and the posterior descending (PD) regions often present problems. Difficulties in determining the appropriate distance between the aorta and coronary artery have been reported to be due to changes in the morphology of the heart following the evolution of Cx and PD. We set an intermediate point (IMP) in advance and then determine graft distance in 2 steps. When using the IMP method, determination of the graft length in the Cx region is not difficult. However, attention should be paid to determine the distance between the IMP and anastomosed site without deforming the heart, as the graft length becomes shorter if the heart as a whole is pulled up by traction of the diaphragm during evolution to the PD region.
Kotoh
K
K
Department of Surgery I, Toyama Medical and Pharmaceutical University, Toyama, Japan.
Fukahara
K
K
Doi
T
T
Senda
K
K
Misaki
T
T
D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods; D006801:Humans; D012501:Saphenous Vein / Q000033:anatomy & histology