A review of coronary artery bypass grafting distal to the total obstruction

: Coronary artery bypass grafting (CABG) distal to the total obstruction has been carried out in 10 patients during 17 month period. There were neither operative deaths nor perioperative myocardial infarction. All patients were free from angina pectoris postoperatively. There were 13 completely obstructed coronary arteries. CABG was successfully placed on 9/9 (100%) of the distal artery filled with collaterals including thread-like caliber, but 0/4 (0%) without opacification suggesting no collaterals. The graftability to the left anterior descending branch was 6/6 (100%), to the circumflex system was 3/5 (60%), and to the right coronary system was 0/2 (0%). Postoperative regional ejection fraction and cardiac index improved significantly. In conclusion, CABG distal to the total obstruction should be performed in case of the distal lumen opacified by collaterals. Especially CABG to the left anterior descending artery might be worth-while.