Complete myocardial revascularization with bilateral internal thoracic artery T graft

Background. The internal thoracic artery is widely recognized as the ideal graft for coronary artery bypass procedures. However, because of the inadeq uate length of the conduit use of bilateral internal thoracic artery grafti ng was not suitable for complete revascularization. To overcome this limita tion, the T graft was introduced in the 1990s. We decided to prospectively assess the safety of this technique. Methods. One hundred six patients with a mean age of 51.5 years underwent c omplete revascularization with an internal thoracic artery T graft. Mean le ft ventricular ejection fraction was 0.60 (range, 0.22 to 0.85). Results. No patient required reexploration for bleeding, and no patient die d within 30 days after operation. On the basis of electrocardiographic chan ges, 3 patients sustained a perioperative myocardial infarction. One patien t had a sternal wound infection. Mean follow-up was 35 months (range, 15 to 61 months). The actuarial survival rate was 99% +/- 1% at 5 years. No myoc ardial infarctions were reported during the follow-up. Seven patients had r ecurrent angina. Eighty patients (76%) underwent postoperative stress tests , and 90% had negative results. Conclusions. Complete myocardial revascularization with the T graft is a sa fe and reliable technique with excellent midterm results. (C) 2000 by The S ociety of Thoracic Surgeons.