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Lucian Stoica
Sidney Chocron
Pierre-Emmanuel Falcoz
Djamel Kaili
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Ann Thorac Surg 2005;79:1068-1069
© 2005 The Society of Thoracic Surgeons

How to do it

How to Tailor A "{pi}" Graft for Complex Myocardial Revascularization: A Variant of the Mammary Loop Technique

Lucian Stoica, MD, PhD*,a, Sidney Chocron, MD, PhDa, Pierre-Emmanuel Falcoz, MDa, Djamel Kaili, MDa, Joseph-Philippe Etievent, MDa

a Department of Thoracic and Cardiovascular Surgery, Hôpital Jean Minjoz, Besançon, France

Accepted for publication December 2, 2003.

* Address reprint requests to Dr Stoica, Department of Thoracic and Cardiovascular, Surgery, Hôpital Jean Minjoz, 3 Bd. Fleming, Besançon 25000, France
l.stoica{at}voila.fr

We present a new pattern for tailoring the "{pi}" graft that uses the advantages of the mammary loop technique. The two internal thoracic mammary arteries are skeletonized. The free right mammary artery is anastomosed end-to-side to the proximal part of the in situ left mammary artery to make a "Y" graft. The distal end of the left mammary artery is anastomosed end-to-side to the middle portion of the right one to form a loop with the two arteries. The loop is severed at the appropriate level at the time of the coronary anastomosis to form a "{pi}" graft. This technique allows a more rational use of the length of the two mammary arteries, because the branch leading to the left anterior descending artery is measured and cut precisely at the time of the anastomosis.






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