How I do it: a new method of myocardial revascularization with use of the radial loop technique

Abstract

We report a technique that allows total arterial myocardial revascularization of the left ventricle by the use of the radial artery as a composite graft. The technique includes anastomosis of the distal end of the radial artery to its more proximal part after division of the conduit from the brachial artery. In this way we create an adjustable loop that can be divided and used as a Y-fashioned conduit according to the needs of revascularization. The main advantages of this technique are that it saves time and facilitates complex arterial revascularization of the lateral and posterior parts of the left ventricle, especially during off-pump revascularization. At least 2 coronary targets can be revascularized with the radial artery in a flexible and safe manner. The radial artery also has important potential opportunities for multiple grafting through minimal-access incisions or endoscopic coronary artery bypass grafting when a critical Y anastomosis is needed inside the chest.