Myocardial Revascularization Using the Arterial T Graft: Which Conduit Should Be Chosen for the Free Graft?


  • Calin Vicol
  • Stephan Raab
  • Michael Beyer
  • Bruno Reichart



Background: The T graft is achieved by the end-to-side implantation of a free arterial graft into the left internal thoracic artery, which remains in situ. Which conduit is best suited as the free graft is still being discussed.

Methods: Two groups of patients are compared. The right internal thoracic artery (RITA) was used as a free graft in group I (n = 129), and the radial artery was used in group II (n = 84).

Results: The RITA was used more often with male patients (P < .02) and with patients presenting a reduced left ventricular ejection fraction (P < .03). The average number of coronary anastomoses per patient was higher in group II than in group I (P < .002). There were no significant differences between the groups in early mortality (0.8% in group I and 1.2% in group II) and morbidity. Postoperative chest tube output was significantly higher in group I than in group II (P < .05). The mean follow-up time was 35.2 ± 28.3 months. There were no significant differences regarding late mortality (6.9% in group I and 5.3% in group II) and the recurrence of angina (group I, 6 cases or 5.5%; group II, 3 cases or 4.2%). Because of the recurrence of angina or questionable chest pain in 22 patients, angiography was performed, and results showed a patency rate of 90.9% in group I and 93.1% in group II.

Conclusions: Based on our experience, we advise using the RITA as a free graft with tall men and also in patients with a reduced left ventricular ejection fraction, diabetes, and obesity. The radial artery should be used with small women if there is a high risk of bleeding and if several coronary anastomoses are necessary.


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How to Cite

Vicol, C., Raab, S., Beyer, M., & Reichart, B. (2005). Myocardial Revascularization Using the Arterial T Graft: Which Conduit Should Be Chosen for the Free Graft?. The Heart Surgery Forum, 6(5), 353-357.