Inverted T graft: Novel technique using composite radial and internal thoracic arteries

Background. Multiple arterial revascularization is feasible because of the excellent long-term patency of the arterial grafts compared with venous gra fts. We present a new operative technique for multiple arterial revasculari zation using composite radial and internal thoracic arterial grafts. Methods. Between January and September 1997, 12 patients had coronary arter y bypass grafting with inverted T graft. The indications for inverted T gra ft were aortic calcification in 4 patients, repeat coronary artery bypass g rafting in 1 patient, and total arterial revascularization in 7 young patie nts. The inverted T graft was constructed by interconnecting the coronary a rteries and radial artery with end-to-side and side-to-side anastomoses, an d by anastomosing the internal thoracic artery to the side of radial artery . Results. Overall, 38 distal anastomoses (average number per patient, 3.2) w ere made with an inverted T graft. There were no deaths or perioperative my ocardial infarctions. Postoperative angiography disclosed that all of the a nastomoses were patent. Conclusion. This technique allows multiple arterial revascularizations with out technical difficulty. It is useful in patients with aortic calcificatio n, repeat coronary artery bypass grafting patients, and young patients who are candidates for total arterial revascularization. (Ann Thoracic Surg 199 9;67:629-31) (C) 1999 by The Society of Thoracic Surgeons.