MODIFIED T-GRAFT FOR TRIPLE-VESSEL DISEASE

Background. Arterial coronary bypass grafts are used in younger patien ts due to the limited long-term patency of saphenous vein grafts. Usin g both internal thoracic arteries in a T graft configuration allows co mplete myocardial revascularization without the need for alternative c onduit. Methods. A prospective analysis of 75 consecutive patients wit h triple-vessel disease who were aged less than 66 years and who had a left ventricular ejection fraction greater than 0.50 was performed fr om November 1994 to November 1995. Seventy-three patients underwent my ocardial revascularization using a modified T graft technique using bo th internal thoracic arteries. Postoperative cardiac enzyme and electr ocardiographic analyses were performed along with routine surgical and cardiologic review to March 1996. Results. There were no deaths or pe rioperative myocardial infarcts, and there was no sternal dehiscence d ue to infection. Five patients had recurrent angina and underwent repe at angiography. Three were treated by single coronary artery angioplas ty and 2 with medical therapy. Conclusions. A modified T graft revascu larization of patients selected by the protocol used in this study is safe. (C) 1997 by The Society of Thoracic Surgeons.