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The Annals of Thoracic Surgery, Vol 57, 33-38, Copyright © 1994 by The Society of Thoracic Surgeons
AJ Tector, S Amundsen, TM Schmahl, DC Kress and M Peter
The T graft is constructed by anastomosing the proximal end of the free
right internal thoracic artery to the side of the attached left internal
thoracic artery. Besides adding considerable reach to the right internal
thoracic artery, this technique allows the left anterior descending
coronary artery and its branches to be bypassed with the attached left
internal thoracic artery. Two hundred eight-seven patients, aged 34 to 86
years (mean age, 64.6 years) received an average of 4.4 internal thoracic
artery to coronary artery anastomoses. Sixty-nine patients had left main
disease, 33 were undergoing first- time reoperations, and two were
reoperated on for the second time. Ejection fraction ranged from 0.20 to
0.70. Operative mortality was 1.7%. Twenty-six patients had postoperative
graft visualization, and 94.7% of the grafts were open. All 45 bypass
grafts from the left internal thoracic artery were patent, and 91% of those
from the right internal thoracic artery were unobstructed. This procedure
requires technical skill with internal thoracic arteries, but it has the
potential of significantly improving long-term event-free survival and
reducing the need for reoperation in patients undergoing coronary artery
bypass grafting.
ARTICLES
Total revascularization with T grafts
Midwest Heart Surgery Institute, Milwaukee, Wisconsin.
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