Effect of modified proximal XXXX of the free right internal thoracic artery: piggyback and foldback techniques.

@entity1 @entity6128 @entity254
OBJECTIVES: Few studies have reported the free right internal thoracic artery (RITA) being used in an aorto-coronary fashion. This study aimed to evaluate the free RITA with modified proximal @entity254 in an aorto-coronary fashion. METHODS: Between January 2000 and December 2012, 282 @entity1 underwent coronary artery bypass grafting with bilateral internal thoracic arteries for complete revascularization of the left coronary system at our institution. The left internal thoracic artery (LITA) was anastomosed to the @entity6128 ( @entity6128 ) and the RITA was anastomosed to the left circumflex branches (LCX). The RITA was used as a free graft in 213 @entity1 (free group) and as an in situ graft in 69 @entity1 (in situ group). Proximal @entity254 of the free RITA onto the ascending aorta was performed in two different ways. We compared early and late results and graft patency of the free RITA with those of the in situ RITA retrospectively. RESULTS: The numbers of anastomoses per @entity1 and anastomoses of the RITA were larger in the free group than in the in situ group (P < 0.01). There was no significant difference in postoperative survival between the groups (free group: 93.3% vs in situ group: 90.0%, P = 0.82). The 5-year patency of the free RITA was higher than that of the in situ RITA (97.0 vs 80.3%, P = 0.01). The 5-year patency of the free RITA was comparable with that of the in situ LITA anastomosed to the @entity6128 (97.0 vs 92.9%, P = 0.28). CONCLUSIONS: The free RITA anastomosed to the LCX might have better late patency than the in situ RITA. The free RITA with modified proximal @entity254 in an aorto-coronary fashion enables complete revascularization of the left coronary system with the in situ LITA to the @entity6128 .
