title: Coronary artery bypass grafting using an abdominal artery as an inflow.
abstract: BACKGROUND
  In multiple bypass surgery, when the ascending aorta cannot be used as an inflow, it is sometimes necessary to use an abdominal artery. This technique is useful when a re-median sternotomy might damage a patent graft in patients undergoing reoperations or when the gastroepiploic artery is unsuitable for use as a graft.
  
  
  METHODS
  The subjects were 17 patients in whom an abdominal artery was used as an inflow. In these 17 patients, 9 underwent surgery for the first operation, while 8 underwent surgery for the reoperation. As an inflow, the gastroduodenal artery was used in 8 patients, the common hepatic artery in 4 patients, the left gastric artery in 3 patients, the right gastric artery in 1 patient, and the middle colic artery in 1 patient. The target coronary artery was the right posterior descending artery in 13 patients, the atrioventricular artery in 2 patients, and the circumflex artery in 4 patients. Sequential bypass was performed on 2 patients.
  
  
  RESULTS
  None of the patients died during surgery. Symptoms disappeared postoperatively in all patients; postoperative angiography showed that all grafts were patent.
  
  
  CONCLUSIONS
  The present technique is useful when the ascending aorta cannot be used as an inflow or when a bypass to a region with a large perfusion area is needed in multiple bypass surgery.
authors.affiliation: Department of Cardiovascular Surgery, Aomori Municipal Hospital, Katta, Aomori City, Japan. takaken@r66.7-dj.com
authors.forename: Kenji
authors.initials: K
authors.lastname: Takahashi
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Daitoku
authors.forename: Masahito
authors.initials: M
authors.lastname: Minakawa
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kondo
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Naito
authors.forename: Shigeru
authors.initials: S
authors.lastname: Oikawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000473:pathology; D001158:Arteries / Q000637:transplantation; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D005260:Female; D041981:Gastrointestinal Tract / Q000098:blood supply*; D006499:Hepatic Artery / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome; D014654:Vascular Patency