IN-SITU RIGHT INTERNAL THORACIC ARTERY GRAFT VIA TRANSVERSE SINUS FORREVASCULARIZATION OF POSTEROLATERAL WALL - EARLY RESULTS IN 116 CASES

The in situ right internal thoracic artery graft brought through the t ransverse sinus was used to revascularize the posterolateral wall in 1 16 patients. Its advantages were assessed retrospectively. The graft w as anastomosed to the circumflex marginal branch in 70 patients (60%) or to the posterolateral branch in 41 patients (35%), One patient died (mortality rate 0.9%). Perioperative myocardial infarction occurred o utside the territory of the right internal thoracic artery graft in 10 patients, four of whom required mechanical support for hemodynamic de terioration. Postoperative early angiography in 114 patients found the graft to be patent in 97.4%. The ratio of the diameter of the right i nternal thoracic artery to that of the recipient marginal branch was 0 .94 +/- 0.18 (n = 69), and that to the posterolateral branch was 0.88 +/- 0.18 (n = 37) (not significantly different). Results of a postoper ative stress test were abnormal in one patient (1/96 tested patients). This retrospective study suggests that the right internal thoracic ar tery brought through the transverse sinus to revascularize the postero lateral wall provided excellent early patency and good clinical result s, even to the most distally located branches. This continues to be ou r procedure of choice for patients with multivessel coronary disease.