Experience with sequential bypass grafts using a vascular punch
Murakami, T.; Yanagi, H.; Irie, H.; Bando, K.; Nakayama, Y.; Mondori, E.; Tago, M.; Nawa, S.; Senoo, Y.; Teramoto, S.
Nihon Kyobu Geka Gakkai 35(1): 20-25
1987
ISSN/ISBN: 0369-4739 PMID: 3572119 Document Number: 299223
Eleven patients underwent sequential bypass graft using either 2.7 mm or 2.4 mm vascular punch. The age of the patients ranged from 46 to 62. Eight patients had angina, 2 patients had myocardial infarction and one patient had combined aortic stenosis and coronary stenosis. There were 2 cases of single vessel disease, 3 cases of two vessel disease, and 6 cases of three vessel disease. Combined operations were AVR and patch graft to the ascending aorta for aortic dissection. Graft flow of 10 sequential grafts ranged from 60 to 180 ml/min, averaged 114 ml/min. Graft flow of 4 single grafts ranged from 35 to 85 ml/min, averaged 52 ml/min. Postoperative angiography revealed occlusion of one single graft, 3 side-to-side anastomoses and 2 end-to-side anastomoses. The proximal segments of the sequential grafts were all patent. The advantages of the use of vascular punch are as follows: 1) This punch affords the same advantage as the diamond-shaped anastomosis, since vein tissue is removed by the punch and the anastomosis would thereby tend to be held open, 2) The anastomosis is rapid and easy, since the standard hole produced can be joined to an incision in the coronary artery with interrupted sutures or continuous suture, 3) the angle of the side-to-side anastomosis can be adjusted with ease.