Off-pump total arterial bypass grafting using bilateral mammary, gastroepiploic, and radial artery

The indication for off-pump coronary artery bypass grafting (CABG) have been expanded as development of the off-pump device has progressed. We present a case of four-vessel revascularization with total arterial graft under a beating heart. All conduits were in situ or composite, and bypass was performed with aorta non-touch technique. Off-pump bypass using in situ quadruple arterial conduits may contribute to a reduction of incidence of perioperative strokes and reduction of the postoperative cardiac events.