Complete myocardial revascularization with bilateral internal thoracic artery T graft.

Abstract Background . The internal thoracic artery is widely recognized as the ideal graft for coronary artery bypass procedures. However, because of the inadequate length of the conduit, use of bilateral internal thoracic artery grafting was not suitable for complete revascularization. To overcome this limitation, 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 complete revascularization with an internal thoracic artery T graft. Mean left ventricular ejection fraction was 0.60 (range, 0.22 to 0.85). Results . No patient required reexploration for bleeding, and no patient died within 30 days after operation. On the basis of electrocardiographic changes, 3 patients sustained a perioperative myocardial infarction. One patient 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 myocardial infarctions were reported during the follow-up. Seven patients had recurrent angina. Eighty patients (76%) underwent postoperative stress tests, and 90% had negative results. Conclusions . Complete myocardial revascularization with the T graft is a safe and reliable technique with excellent midterm results.