title: "Pouch Technique" Makes Proximal Anastomosis of Free Internal Thoracic Artery Graft to Ascending Aorta Easy and Safe in Coronary Artery Bypass Surgery.
abstract: OBJECTIVE
  The proximal anastomosis of free right internal thoracic artery to ascending aorta is technically difficult when the caliber is not enough.
  
  
  METHODS
  We incise the proximal stump of the graft longitudinally for 10 mm. One side of start point of longitudinal incision is sewn to the end point of incision by 7-0 polypropylene. The folded sideline (5 mm length) is then closed with a running suture, then formation of pouch like anastomotic end is accomplished.
  
  
  RESULTS
  We used this technique in consecutive 34 patients who underwent coronary artery bypass surgery including revascularization to circumflex arteries. Postoperative angiography revealed 97% patency. It does not need another graft material like saphenous vein or radial artery, and possible not only in on pump surgery but also in off pump.
  
  
  CONCLUSIONS
  This new "Pouch technique" will make it easy to use right internal thoracic artery as a free graft in coronary artery bypass surgery.
authors.affiliation: Cardiovascular Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Uchida
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Imoto
authors.forename: Norihisa
authors.initials: N
authors.lastname: Karube
authors.forename: Susumu
authors.initials: S
authors.lastname: Isoda
authors.forename: Shota
authors.initials: S
authors.lastname: Yasuda
authors.forename: Toru
authors.initials: T
authors.lastname: Yasutsune
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013895:Thoracic Arteries / Q000637:transplantation*; D016896:Treatment Outcome; D014654:Vascular Patency