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Anastomosis of Small Arteries: Implications for Coronary Artery Grafts in Asians

Department of Cardiac, Thoracic and Vascular Surgery, The Heart Institute, National Healthcare Group, Singapore

For reprint information contact: Reida M El Oakley, MD Tel: 966 5 5160 9140 Fax: 966 1 4653 0105 Email: surrmo{at}nus.edu.sg, Heart Centre, King Fahd Medical City, PO Box 59046, Riyadh 11525, Kingdom of Saudi Arabia.

The internal mammary artery (IMA) in patients with small body surface area, frequently found in the Asian population, is often small and delicate and can be easily damaged during suturing, particularly at the "toe" of the anastomosis. This may lead to less frequent utilization of the IMA as a bypass conduit. We describe a technique for anastomosing a small-caliber IMA to a coronary artery, using the tip of the graft as an autologous buttress to reinforce the toe of the anastomosis.