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Ann Thorac Surg 2007;83:1911-1912
© 2007 The Society of Thoracic Surgeons

How To Do It

Total Arterial Coronary Revascularization Using Arterial Bypass Circle With Multiple Inflows

Reida M. El Oakley, MD*, Hamad F. Al Habib, MBBS

Department of Cardiac Surgery, Prince Salman Heart Center, Riyadh, Kingdom of Saudi Arabia

Accepted for publication June 23, 2006.

* Address correspondence to Dr El Oakley, National University of Singapore, Prince Salman Heart Center, King Fahad Medical City, PO Box 59046, Riyadh, 11525 Kingdom of Saudi Arabia (Email: surrmo{at}nus.edu.sg).

Coronary artery bypass techniques, currently applied to maximize the benefits of multiple arterial coronary conduits, render the newly constructed myocardial flow dependent on a single source "inflow" of blood. We describe a technique for total arterial coronary revascularization with multiple inflows; the distal end of the pedicled right internal thoracic artery is anastomosed to the distal end of a free radial artery, and the other end of the radial artery is then connected to the ascending aorta. This vascular circle, passed in a retro-cardiac fashion, is used to revascularize the inferio-lateral surface of the heart using multiple side-to-side anastomoses. The "sacred" left internal thoracic artery is reserved to revascularize the anterior wall of the myocardium, independent of the arterial circle.






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Copyright © 2007 by The Society of Thoracic Surgeons.