Modified T graft for triple-vessel disease

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery
• Vascular Grafting

Background:

• Saphenous vein grafts have limited long-term patency, necessitating alternative conduits for coronary artery bypass in younger patients.
• Internal thoracic arteries offer a viable alternative conduit for myocardial revascularization.
• A T graft configuration using bilateral internal thoracic arteries enables complete myocardial revascularization.

Purpose of the Study:

• To evaluate the safety and efficacy of a modified T graft technique using bilateral internal thoracic arteries for myocardial revascularization.
• To assess the outcomes of complete revascularization in patients with triple-vessel disease using this arterial graft configuration.

Main Methods:

• Prospective analysis of 75 consecutive patients (age < 66, LVEF > 0.50) with triple-vessel disease.
• 73 patients underwent myocardial revascularization with a modified T graft using both internal thoracic arteries.
• Postoperative assessment included cardiac enzymes, ECG, and routine surgical/cardiologic review.

Main Results:

• No deaths or perioperative myocardial infarcts were reported.
• No instances of sternal dehiscence due to infection occurred.
• Five patients experienced recurrent angina, with 3 treated by angioplasty and 2 by medical therapy.

Conclusions:

• Modified T graft revascularization using bilateral internal thoracic arteries is a safe procedure for selected patients.
• This technique provides a viable option for complete myocardial revascularization, potentially improving long-term outcomes.