Case report

Axillary artery to left anterior descending coronary artery bypass with an externally stented graft: a technical report

Thanos Athanasiou¹ , Emmanouil I Kapetanakis¹ , Christopher Rao¹ , Loris Salvador² and Ara Darzi¹

¹  Imperial College of Science, Technology and Medicine, Department of Surgical, Oncology and Technology, St. Mary's Hospital, London, UK

²  Cardiothoracic Surgery Department, Treviso Ca' Foncello Hospital, Treviso, Italy

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Journal of Cardiothoracic Surgery 2008, 3:6doi:10.1186/1749-8090-3-6

Published:	12 February 2008

Abstract

With the proliferation of minimally invasive cardiac surgery a number of alternative inflow sites for coronary artery bypass grafting have been utilized, especially in higher risk patients. The use of axillary-coronary artery bypass is a safe and effective alternative especially in the case of patients requiring redo coronary revascularization. However, the length and convoluted course of the axillary-coronary vein graft makes is susceptible to twisting, trauma and neointimal hyperplasia. We therefore report a case of an axillary-coronary artery bypass in a high risk patient in which a Dacron conduit was used to externally support and protect the vein graft to the left anterior descending artery. Surgical technique and considerations are presented and discussed.