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George P. Stavropoulos
George M. Palatianos
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Ann Thorac Surg 2002;73:1990-1992
© 2002 The Society of Thoracic Surgeons


How to do it

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

Sotirios N. Prapas, MD*a, Constantine E. Anagnostopoulos, MDa,b, Vassilios N. Kotsis, MDa,b, George P. Stavropoulos, MDa,b, Alexis V. Sidiropoulos, MDa,b, Olga G. Ananiadou, MDa,b, George M. Palatianos, MDc,b

a Department of Cardiac Surgery, Henry Dunant Hospital, Athens, Greece
b Department of Cardiac Surgery, Columbia University College of Physicians and Surgeons at St. Luke’s/Roosevelt Hospital Center, New York, New York, USA
c Onassis Cardiac Surgery Center, Athens, Greece

Accepted for publication February 5, 2002.

* Address reprint requests to Dr Prapas, Department of Cardiac Surgery, Henry Dunant Hospital, 107 Mesoghion Ave, Athens 11526, Greece
e-mail: sprapas{at}dunanthospi.gr

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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