There is evidence that the use of Y-grafts attached to the left internal mammary artery
– to – left anterior descending artery graft may compromise the patency of the distal
limb of the left internal mammary artery. We describe a technique (split radial technique)
that avoids the use of Y-grafts by constructing two aorto-coronary grafts from a single
radial artery. The split radial technique requires the harvesting of the radial artery
in its entirety from the brachial bifurcation to the radial styloid. The first radial
artery distal anastomosis is performed and the required length of conduit is determined.
The conduit is transected, leaving a sufficiently long radial segment for a second
aorto-coronary graft. A clinical follow-up 41 weeks after surgery of the first 37
patients in whom the split radial technique was used showed no deaths or major complications.
This suggests that the split radial technique is a useful and safe way to maximise
the use of radial artery conduit and to avoid the potential risk of compromising internal
mammary artery patency with Y-grafts.
There is evidence that the use of Y-grafts attached to the left internal mammary artery
may compromise the patency of the distal limb of the left internal mammary artery.
We describe the split radial technique of constructing two aorto-coronary graft segments
from a single radial artery that can be used to avoid the use of Y-grafts.
Keywords
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© 2004 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.