Total arterial revascularization using multiple in situ arterial conduits is feasible and provides excellent graft patency in patients with left main trunk disease and a single coronary artery.
Supports feasibility of multi-conduit arterial revascularization in complex left main anatomy; leaves open need for prospective data on durability and outcomes.
A 52-year-old male patient with left main trunk disease and absent right coronary artery underwent successful coronary artery bypass grafting with in situ arterial conduits. Bilateral internal mammary arteries and the gastroepiploic artery were employed, with the inferior epigastric artery as a composite graft to the left internal mammary artery. The postoperative angiogram showed excellent patency of all 4 grafts and cardiac performance during exercise monitored by scintigram was found to be satisfactory.
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Nabuchi et al. (1997) studied this question.
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