Use of extended radial artery conduit for complete arterial revascularization

We have developed a new technique to elongate the radial artery (RA) with the distal segment of the left internal thoracic artery (LITA). The left anterior descending (LAD) artery is examined to define the site of the LITA-LAD anastomosis and the length of LITA required to perform the anastomosis. The distal segment of the LITA beyond this length is divided in order to elongate the RA. This extended conduit is long enough to perform complete arterial revascularization and to reach the ascending aorta for the proximal anastomosis. Between January 1998 and December 2010, 113 patients were operated on using this technique. There was no early mortality among the whole group. Two patients (1.8%) had perioperative myocardial infarction. Three patients (3.5%) had re-interventions. We conclude that this technique makes the optimal use of both arterial conduits and could be a valuable alternative option for patients who are selected for complete arterial revascularization.