REOPERATION IN PATIENTS WITH CLOSED SVG AND PATENT LITA-LAD GRAFT - T-GRAFT APPROACH

Selection of the bypass graft that the patient has demonstrated will r emain patent and free from critical atherosclerosis is a most importan t part of coronary artery bypass reoperations. Sixteen patients in who m a patent left internal thoracic artery-left anterior descending coro nary artery bypass graft and obstructed or closed saphenous vein graft s to other coronary arteries were visualized underwent reoperation. To reach the inadequately perfused circumflex and right coronary arterie s, the right internal thoracic artery was anastomosed to the left inte rnal thoracic artery as a T graft and then was attached to the circumf lex and right coronary artery branches. All patients survived the proc edure and are free from angina. There were no perioperative myocardial infarctions, and there was no suggestion of hypoperfusion by the graf ts. We believe this technique may reduce the incidence of graft failur e in patients undergoing reoperative coronary artery bypass grafting.