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.
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- Influence of the internal-mammary-artery graft on 10-year survival and other cardiac events.N Engl J Med. 1986; 314: 1-6
- Revival of the radial artery for coronary artery bypass grafting.Ann Thorac Surg. 1992; 54: 652-659
- Midterm clinical and angiographic results of radial artery grafts used for myocardial revascularization.J Thorac Cardiovasc Surg. 1998; 116: 1015-1021
- The radial artery versus the saphenous vein graft in contemporary CABG: a case-matched study.Ann Thorac Surg. 2001; 71: 180-186
- Total revascularisation with T grafts.Ann Thorac Surg. 1994; 57: 33-38
- Radial artery and inferior epigastic artery in composite grafts: improved midterm angiographic results.Ann Thorac Surg. 1995; 60: 517-524
- Exclusive Y graft operation for multivessel coronary revascularization.Ann Thorac Surg. 1999; 68: 1612-1618
- Postoperative radial artery angiography for coronary artery bypass surgery.Eur J Cardio-Thoracic Surg. 2000; 17: 294-304
- TAR and the Y-graft: the golden myth, the tragic reality.Eur J Cardio-Thoracic Surg. 2001; 19: 541-542
- A simplified method of harvesting and dilating the radial artery achieves acceptable clinical outcomes.Aust NZ J Surg. 2000; 70: 366-370
- Coronary artery bypass grafting: The Society of Thoracic Surgeons National Database Experience.Ann Thorac Surg. 1994; 57: 12-19
© 2004 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.