title: Total arterial coronary revascularization using arterial bypass circle with multiple inflows.
abstract: Coronary artery bypass techniques, currently applied to maximize the benefits of multiple arterial coronary conduits, render the newly constructed myocardial flow dependent on a single source "inflow" of blood. We describe a technique for total arterial coronary revascularization with multiple inflows; the distal end of the pedicled right internal thoracic artery is anastomosed to the distal end of a free radial artery, and the other end of the radial artery is then connected to the ascending aorta. This vascular circle, passed in a retro-cardiac fashion, is used to revascularize the inferio-lateral surface of the heart using multiple side-to-side anastomoses. The "sacred" left internal thoracic artery is reserved to revascularize the anterior wall of the myocardium, independent of the arterial circle.
authors.affiliation: Department of Cardiac Surgery, Prince Salman Heart Center, Riyadh, Kingdom of Saudi Arabia. surrmo@nus.edu.sg
authors.forename: Reida M
authors.initials: RM
authors.lastname: El Oakley
authors.forename: Hamad F
authors.initials: HF
authors.lastname: Al Habib
mesh_terms: D000714:Anastomosis, Surgical; D023921:Coronary Stenosis / Q000601:surgery; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D008323:Mammary Arteries / Q000601:surgery*; D017534:Radial Artery / Q000637:transplantation*