PMID- 10935400
OWN - NLM
STAT- MEDLINE
DCOM- 20001027
LR  - 20061115
IS  - 0021-5252 (Print)
IS  - 0021-5252 (Linking)
VI  - 53
IP  - 9
DP  - 2000 Aug
TI  - [Coronary artery bypass grafting using side-to-side anastomosis].
PG  - 747-9
AB  - Recently, to obtain better long-term patency after coronary artery bypass 
      grafting (CABG) arterial conduits such as internal mammary arteries (IMAs) and 
      the right gastroepiploic artery have been frequently used. For coronary site 
      anastomosis, end-to-side anastomosis is common. These conduits have a smaller 
      diameter than the saphenous vein graft, so that, usually, longitudinal slits are 
      made on the distal end of these grafts to obtain a more effective anastomotic 
      orifice area. However, there is a potential for anastomotic leakage due to 
      mismatch between the incision of the coronary artery and the arterial graft. We 
      report here the efficacy of side-to-side anastomosis using small arterial 
      conduits. This method has several advantages. Firstly, there is no chance of 
      anastomotic leakage, since the coronary incision and graft incision can be 
      perfectly matched. Secondly, if there is at least a 5-mm distance between the 
      distal end of the graft incision and the surgical clip, the graft incision can be 
      extended during anastomosis for adjustment. Thirdly, the distal end of the graft 
      can be held beyond the surgical clip by forceps without damaging the arterial 
      graft, which makes it easier for the anastomosis to be performed. Finally, the 
      anastomosis can be checked by passing a probe through the distal end of the graft 
      after removing the surgical clip. Also dye can be injected from the distal end of 
      the graft at "Off Pump CABG", intraoperatively. This technique can be applied not 
      only for distal end anastomosis, but also for proximal end, using free IMA to the 
      ascending aorta and to make a Y-graft.
FAU - Niinami, H
AU  - Niinami H
AD  - Department of Cardiovascular Surgery, Tokyo Women's Medical University Daini 
      Hospotal, Japan.
FAU - Takeuchi, Y
AU  - Takeuchi Y
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Kyobu Geka
JT  - Kyobu geka. The Japanese journal of thoracic surgery
JID - 0413533
SB  - IM
MH  - Anastomosis, Surgical/methods
MH  - Coronary Artery Bypass/*methods
MH  - Epigastric Arteries/transplantation
MH  - Humans
MH  - Mammary Arteries/transplantation
EDAT- 2000/08/10 11:00
MHDA- 2001/02/28 10:01
CRDT- 2000/08/10 11:00
PHST- 2000/08/10 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/08/10 11:00 [entrez]
PST - ppublish
SO  - Kyobu Geka. 2000 Aug;53(9):747-9.