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Ann Thorac Surg 2006;82:69-73
© 2006 The Society of Thoracic Surgeons

Original article: Cardiovascular

Coronary Artery Bypass Grafting Using an Abdominal Artery as an Inflow

Kenji Takahashi, MD * , Kazuyuki Daitoku, MD, Masahito Minakawa, MD, Norihiro Kondo, MD, Kazuhiro Naito, MD, Shigeru Oikawa, MD

Department of Cardiovascular Surgery, Aomori Municipal Hospital, Aomori, Japan

Accepted for publication October 31, 2005.

* Address correspondence to Dr Takahashi, Department of Cardiovascular Surgery, Aomori Municipal Hospital, Katta 1-14-2, Aomori City, 030-0821, Japan (Email: takaken{at}r66.7-dj.com).

BACKGROUND: In multiple bypass surgery, when the ascending aorta cannot be used as an inflow, it is sometimes necessary to use an abdominal artery. This technique is useful when a re-median sternotomy might damage a patent graft in patients undergoing reoperations or when the gastroepiploic artery is unsuitable for use as a graft.

METHODS: The subjects were 17 patients in whom an abdominal artery was used as an inflow. In these 17 patients, 9 underwent surgery for the first operation, while 8 underwent surgery for the reoperation. As an inflow, the gastroduodenal artery was used in 8 patients, the common hepatic artery in 4 patients, the left gastric artery in 3 patients, the right gastric artery in 1 patient, and the middle colic artery in 1 patient. The target coronary artery was the right posterior descending artery in 13 patients, the atrioventricular artery in 2 patients, and the circumflex artery in 4 patients. Sequential bypass was performed on 2 patients.

RESULTS: None of the patients died during surgery. Symptoms disappeared postoperatively in all patients; postoperative angiography showed that all grafts were patent.

CONCLUSIONS: The present technique is useful when the ascending aorta cannot be used as an inflow or when a bypass to a region with a large perfusion area is needed in multiple bypass surgery.


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Invited commentary
Michael A. Savitt and Alfred J. Tector
Ann. Thorac. Surg. 2006 82: 73. [Extract] [Full Text] [PDF]



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M. A. Savitt and A. J. Tector
Invited commentary.
Ann. Thorac. Surg., July 1, 2006; 82(1): 73 - 73.
[Full Text] [PDF]


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