Free arterial graft with domino patch for coronary revascularization

To improve the outcomes of coronary revascularization with free arterial grafts, we have devised a composite method that uses free arterial grafts with an arterial wall patch. After an arterial graft is anastomosed to the left external iliac artery (EIA), the EIA wall is excised (like a collar) and anastomosed to the aorta. The defect on the EIA is repaired with a vascular graft patch. Our domino patch method is simple, and it causes minimal wall thickness mismatch and allows the use of various arterial grafts anastomosed to any coronary artery. The procedures and early results are reported.