title: Off-pump coronary artery bypass grafting using a bilateral internal mammary artery Y graft.
abstract: OBJECTIVE
  To evaluate the outcome of off-pump coronary artery bypass grafting (OPCABG) using a bilateral internal mammary artery (BIMA) Y configuration graft to achieve total arterial myocardial revascularization.
  
  
  METHODS
  From October 2002 to December 2008, 208 patients (196 males and 12 females) underwent OPCABG using a BIMA Y configuration graft. The average age of the patients was 56.5 ± 11.3 years, with an age range of 33-78 years. A total of 167 (80.2%) cases had triple-vessel disease. Left main stem disease was found in 33 (15.9%) cases, and double-vessel disease was found in 8 (3.9%) cases. The semi-skeletonization technique was used to harvest the two internal mammary arteries (IMAs), and then the free right internal mammary artery was connected end-to-side to the left internal mammary artery (LIMA) in situ to complete the Y configuration graft. Off-pump and sequential anastomosis methods were used to perform coronary artery bypass surgery in all patients. Graft patency was assessed intra-operatively with the HT311 transit time flowmeter.
  
  
  RESULTS
  A total of 728 distal anastomoses were performed in 208 patients, with the average being 3.5 ± 1.3 per person. No one died or experienced recurrent angina within 30 days after the operation.
  
  
  CONCLUSIONS
  OPCABG using the BIMA Y graft was safe and effective to achieve total arterial revascularization. This method avoids surgical operation on the ascending aorta and other incisions.
authors.affiliation: Department of Cardiac Surgery, Capital Medical University, Beijing Anzhen Hospital, Beijing 100029, China.
authors.forename: Cheng-Xiong
authors.initials: CX
authors.lastname: Gu
authors.forename: Jun-Feng
authors.initials: JF
authors.lastname: Yang
authors.forename: Hong-Chao
authors.initials: HC
authors.lastname: Zhang
authors.forename: Hua
authors.initials: H
authors.lastname: Wei
authors.forename: Ling-Ke
authors.initials: LK
authors.lastname: Li
keywords: Bilateral internal mammary arteries; Coronary artery bypass grafting; Internal mammary artery; Off-pump