Total arterial revascularization in multivessel coronary artery disease with left and right internal thoracic artery: The Y graft technique

Background: Many different surgical techniques for total arterial grafting have been reported. We reported our results of double mammary Y graft for total arterial revascularization in the treatment of multivessel ischemic heart disease. Materials and Methods: Between January 2003 and September 2009, 452 patients underwent myocardial revascularization using two internal mammary arteries in a y-graft configuration. The mean age was 61 ± 8.7 years. 399 patients (88.3%) were male. The preoperative data were collected retrospectively. Results: The mean number of anastomosis for patients was 3.7 (range 2-6). The mean cross-clamp time was 44.6 min (range 16-106 min), and the mean extracorporeal circulation time was 56.9 min (range 22-175 min). Eleven patients were operated off-pump (2.4%). The in-hospital mortality was 0.8% (4/452 patients). The incidence of peri-operative infarction was 0.4%, re-operation for bleeding 7.1% and deep sternal wound infection 3.1%. The actuarial survival rate was 98.4 ± 11% at 3 years, and the freedom from re-intervention was 100%. Conclusion: In our experience the double mammary Y configuration provides a simple and reproducible technique that allows a complete revascularization in multivessel disease with very low morbidity and mortality. The follow-up of our patients confirmed the effectiveness of the procedure in term of survival, re-intervention and symptoms relief. © 2010 Indian Association of Cardiovascular-Thoracic Surgeons.