Abstract
ObjectiveTo evaluate the outcome of off-pump coronary artery bypass grafting (OPCABG) using a bilateral internal mammary artery (BIMA) Y configuration graft to achieve total arterial myocardial revascularization.MethodsFrom October 2002 to December 2008, 208 patients (196 males and 12 females) underwent OPCABG using a BIMA Y configuration graft. The average age of the patients was 56.5 ± 11.3 years, with an age range of 33–78 years. A total of 167 (80.2%) cases had triple-vessel disease. Left main stem disease was found in 33 (15.9%) cases, and double-vessel disease was found in 8 (3.9%) cases. The semi-skeletonization technique was used to harvest the two internal mammary arteries (IMAs), and then the free right internal mammary artery was connected end-to-side to the left internal mammary artery (LIMA) in situ to complete the Y configuration graft. Off-pump and sequential anastomosis methods were used to perform coronary artery bypass surgery in all patients. Graft patency was assessed intra-operatively with the HT311 transit time flowmeter.ResultsA total of 728 distal anastomoses were performed in 208 patients, with the average being 3.5 ± 1.3 per person. No one died or experienced recurrent angina within 30 days after the operation.ConclusionsOPCABG using the BIMA Y graft was safe and effective to achieve total arterial revascularization. This method avoids surgical operation on the ascending aorta and other incisions.
Highlights
A Y graft is a graft formed from the following: the left internal mammary artery (LIMA) connected to the left anterior descending (LAD) artery and the free right internal mammary artery (RIMA) is connected to the LIMA and to a marginal artery of the left circumflex artery (LCX)
To evaluate the outcome of off-pump coronary artery bypass grafting (OPCABG) using a bilateral internal mammary artery (BIMA) Y configuration graft to achieve total arterial myocardial revascularization
We summarize our recent experience with off-pump coronary artery bypass surgery using a BIMA Y graft in China
Summary
A Y graft is a graft formed from the following: the left internal mammary artery (LIMA) connected to the left anterior descending (LAD) artery and the free right internal mammary artery (RIMA) is connected to the LIMA and to a marginal artery of the left circumflex artery (LCX). Since the internal mammary artery (IMA) conduit for coronary artery bypass grafting (CABG) has better long-term results than saphenous vein grafts (SVGs),[1] the LIMA graft is considered the best graft for bypassing the LAD coronary artery.[2,3,4] Use of the RIMA, in place of the LIMA, may produce the same results.[5,6,7] Barn & Barnett[8], Tector et al.,[9] and Barr et al.[10] proposed that the Y or T graft procedure should be carried out by anastomosing the proximal end of the free RIMA to the side of the attached. Correspondence to: Jun-Feng Yang, Professor, Department of Cardiac.
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