Coronary artery bypass grafting using a bifurcating radial artery

Area of Science:

• Cardiovascular Surgery
• Vascular Grafting
• Interventional Cardiology

Background:

• Coronary artery bypass grafting (CABG) is a standard treatment for severe coronary artery disease.
• Graft selection and preparation are critical for successful CABG outcomes.
• The radial artery is a viable conduit for arterial grafting, but its use in complex branching patterns requires innovative techniques.

Purpose of the Study:

• To evaluate the feasibility and efficacy of using a bifurcated left radial artery as a single conduit for coronary artery bypass grafting to multiple branches of the circumflex artery.
• To assess the patency of the radial artery graft in a complex arterial revascularization scenario.

Main Methods:

• A 61-year-old male patient with angina pectoris underwent elective coronary artery bypass grafting.
• The left radial artery was harvested and found to have a distal bifurcation.
• The bifurcated radial artery was used as a Y-graft, with each distal end anastomosed to separate posterolateral branches (PLA1 and PLA2) of the circumflex artery.

Main Results:

• The bifurcated left radial artery was successfully utilized as a composite conduit for bypass grafting to both PLA1 and PLA2.
• Postoperative coronary angiography confirmed good patency of both limbs of the radial artery graft.
• The patient's angina pectoris was addressed with successful revascularization.

Conclusions:

• The bifurcated left radial artery can be effectively employed as a single conduit for simultaneous bypass grafting to multiple target vessels in the coronary circulation.
• This technique offers a promising alternative for arterial grafting in complex coronary anatomy, potentially improving surgical efficiency and graft utilization.