[Off-pump coronary artery bypass grafting using in-situ right internal thoracic artery extended with radial artery as I-composite graft].
OBJECTIVE
The purpose of this study is to assess the feasibility of utilizing the proximal right internal thoracic artery (RITA) extended with the radial artery (RA) as I-composite graft (RITA-RA graft) in off-pump coronary artery bypass grafting (OPCAB), which preserves the left internal thoracic artery to the left anterior descending artery as an isolated graft and the ascending aorta no-touch technique.


METHODS
Between January 2002 and August 2006, 37 patients (aged 67.4+/-7.5 years, 86.5% male) underwent OPCAB using RITA-RA graft. All grafts were harvested in a skeletonized fashion. RITA transected at the middle portion was extended with entirely dissected RA. RITA-RA graft was anastomosed to 1 or 2 lateral artery in a parallel sequential pattern.


RESULTS
The total number of distal anastomoses of RITA-RA graft was 48. The early graft patency rate was 97.9%. Five cases (13.5%) needed intra-aortic balloon pumping support during operation. Only 1 patient (2.7%) required ventilator support longer than 24 hours. The percentage of patients requiring homologous blood transfusion was 13.5%. There was no cerebrovascular accident or mediastinitis in the postoperative course. All patients were discharged from hospital.


CONCLUSIONS
OPCAB using RITA-RA graft is feasible and safe. It provides satisfactory early clinical and angiographic outcomes.
Tanaka
Keita
K
Department of Cardiovascular Surgery, Cardiovascular Center, Toranomon Hospital, Tokyo, Japan.
Naruse
Y
Y
Sato
K
K
D000368:Aged; D000369:Aged, 80 and over; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008875:Middle Aged; D011379:Prognosis; D017534:Radial Artery / Q000637:transplantation*