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Significance of Right Internal Thoracic Artery as Proximal Anastomotic Site

First Department of Surgery Osaka University Medical School Osaka, Japan

For reprint information contact: Nobuaki Hirata, MD Tel: 81 797 87 1161 Fax: 81 797 87 5624 Division of Cardiovascular Surgery, Takarazuka Municipal Hospital, 4-5-1 Kohama, Takarazuka, Hyogo 665-0827, Japan.

The efficacy of the right internal thoracic artery as the proximal anastomosis site in patients with a severely atherosclerotic ascending aorta was evaluated. Coronary artery bypass grafting was performed in 5 patients in whom the right internal thoracic artery was selected as the proximal anastomotic site. The graft flow in the right internal thoracic artery plus saphenous vein or radial artery graft was 52 ± 34 mL•min^–1 (range, 30 to 111 mL•min^–1). The right internal thoracic artery was found to supply adequate graft flow even to the sequential graft, in each patient. The right internal thoracic artery should be kept in mind when it is difficult to determine the best site for a proximal anastomosis in patients with severe atherosclerosis of the ascending aorta.