Foldback technique for aortic anastomosis of free right internal thoracic artery in coronary artery bypass grafting

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• 作者：Toshiaki Ito (1)
  Tomonobu Abe (1)
  Koji Yamana (1)
  Tomo Yoshizumi (1)
  Tamami Kawamura (1)
  Masatoshi Sunada (1)
  
• 关键词：Anastomosis ; Coronary artery bypass grafting ; Arterial grafts
• 刊名：General Thoracic and Cardiovascular Surgery
• 出版年：2009
• 出版时间：December 2009
• 年：2009
• 卷：57
• 期：12
• 页码：678-680
• 全文大小：212KB
• 参考文献：1. Burfeind WR Jr, Glower DD, Wechsler AS, Tuttle RH, Shaw LK, Harrell FE Jr, et al. Single versus multiple internal mammary artery grafting for coronary artery bypass: 15 year followup of a clinical practice trial. Circulation 2004;110(suppl):27-5. CrossRef
  2. Schimert G, Vidne BA, Lee AB Jr. Free internal mammary artery graft: an improved surgical technique. Ann Thorac Surg 1975;19:474-77. CrossRef
  3. Levinsky L, Lajos TZ, Lee AB Jr, Espersen C, Schimert G. The revival of the horseshoe graft (side-to-side saphenous vein to aorta anastomosis). Thorac Cardiovasc Surg 1979;27:322-24. CrossRef
  4. Nakamura Y, Kobayashi J, Tagusari O, Bando K, Niwaya K, Nakajima H, et al. Early results of complete off-pump coronary revascularization using left internal thoracic artery with composite radial artery. Jpn J Thorac Cardiovasc Surg 2003;51:10-5. CrossRef
  
• 作者单位：Toshiaki Ito (1)
  Tomonobu Abe (1)
  Koji Yamana (1)
  Tomo Yoshizumi (1)
  Tamami Kawamura (1)
  Masatoshi Sunada (1)
  
  1. Department of Cardiovascular Surgery, Japanese Red Cross Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura, Nagoya, 453-8511, Japan
  

文摘

We herein report a new technique that we term “foldback plasty-for stenosis-free proximal anastomosis of free arterial grafts without using any other interposition materials. The arterial graft is first anastomosed to the aorta in side-to-side fashion, leaving 1 cm of remnant tissue at the proximal end. The reverse side of the graft is then opened longitudinally, starting at the proximal end, to just distal to the aortic anastomosis site. The new proximal graft flap is folded back and sutured onto the graft to close the longitudinal opening. The proximal anastomosis site is enlarged only by the graft tissue, and stenosis can be avoided even if the graft has a small caliber.