T-GRAFT - A NEW METHOD OF CORONARY ARTERIAL REVASCULARIZATION

We present early results in 486 patients undergoing total coronary art ery revascularization using a T-graft constructed from the attached le ft internal thoracic artery (RITA) and the free right internal thoraci c artery (RITA). The anterior and anterolateral areas of the heart are by-passed with the LITA and the inferolateral inferior and posterior areas are by-passed with the RITA. These patients received an average of 4.34 distal anastomoses with as many as four from each of the limbs of the T-graft. Ages ranged from 29 to 89 years and ejection fraction s from 15 to 79%. Sixty-six patients were undergoing first reoperation s and 6 received T-grafts at their second reoperation. The mortality a t 30 days was 2.3%. Two of 92 women and 9 of 394 men expired. The peri operative infarction rate was 1.2%. Postoperative angiography in 34 pa tients showed 98.3% of LITA and 86.5% of RITA anastomoses to be patent . There was a slightly higher patency observed in women. The T-graft t echnique can be applied to nearly all patients with 3 vessel coronary artery disease with low operative mortality. Precise technique with hi gh power magnification is crucial. This procedure has the potential of avoiding further invasive procedures due to graft deterioration in ma ny patients with 3 vessel coronary artery disease.