A new pattern for using both thoracic arteries to revascularize the entire heart: the pi-graft.

Prapas, Sotirios N; Anagnostopoulos, Constantine E; Kotsis, Vassilios N; Stavropoulos, George P; Sidiropoulos, Alexis V; Ananiadou, Olga G; Palatianos, George M · Ann Thorac Surg · 2002

other · Level V

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Abstract

We present a complex graft for total arterial revascularization based on bilateral skeletonized internal thoracic arteries (ITA). The lower two-thirds of the free right ITA is anastomosed to the proximal segment of the left in situ ITA using the T-graft technique (Tector-Barner-Calafiore). The free, transected distal part of the left ITA is then anastomosed end-to-side on free right ITA (T-on-T anastomosis). In addition, the technique may use another graft extending the proximal third of the in situ right ITA with the free radial artery for right-sided revascularization. The entire operation can be performed off-pump to avoid any procedure on the ascending aorta.

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