title: Revascularization of left anterior descending (LAD) artery with in situ left internal thoracic artery (LITA) and coronary-coronary free LITA grafts: 12-year patency.
abstract: BACKGROUND
  We aim to present a patient with coronary-coronary bypass grafting (CCBG), left anterior descending-left anterior descending (LAD-LAD) coronary artery bypass with left internal thoracic artery (LITA), and provide the 12-year follow-up angiogram to confirm the longest reported patency.
  
  
  RESULTS
  A 57-year-old man with three vessel disease where LAD had multiple lesions was operated on. LITA with pedicle was grafted in situ onto the proximal LAD, and the distal residual segment was used as a free LITA graft to bypass the distal stenosis. The postoperative course was uneventful. The patient has been recently readmitted to our clinic with atypical chest pain. In angiography, all of the bypasses, including the free LITA graft, were patent.
  
  
  CONCLUSIONS
  We used free LITA graft to bypass the distal lesions of LAD in selected patients as a valid alternative to sequential bypass grafting. To the best of our knowledge, this is the only angiographic view of a CCBG in LAD with LITA graft confirming the long-term patency.
authors.affiliation: Department of Cardiovascular Surgery, Baskent University, Istanbul, Turkey.
authors.forename: Oguz
authors.initials: O
authors.lastname: Omay
authors.forename: Emre
authors.initials: E
authors.lastname: Ozker
authors.forename: Cenk
authors.initials: C
authors.lastname: Indelen
authors.forename: Kaya
authors.initials: K
authors.lastname: Suzer
mesh_terms: D000789:Angina, Unstable / Q000000981:diagnostic imaging / Q000473:pathology; D001026:Coronary Artery Bypass; D003331:Coronary Vessels / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging; D009204:Myocardial Revascularization; D013997:Time Factors; D019737:Transplants; D014463:Ultrasonography; D014654:Vascular Patency