Bifid proximal anastomosis technique of radial artery

We have modified proximal anastomosis of radial artery to reduce technical problems due to wall thickness disparity between radial artery and ascending aorta. Bifid proximal anastomosis of both radial arteries is done just after cannulation without cardiopulmonary bypass initiation. Proximal sides of two radial arteries are spatulated with thin incisions. Closer sides of radial arteries are sutured with 8/0 polypropylene suture. Then side clamp is applied on the ascending aorta. The proximal anastomosis is performed directly onto a 5-mm punched opening in the ascending aorta with continuous 6/0 polypropylene. Thus we create a graft with bifid proximal anastomosis.