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High-Dose Isosorbide Dinitrate for Myocardial Revascularization With Composite Arterial Grafts  Jacob Gurevitch, MD, Hylton I Miller, MB, Itzhak Shapira,

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Presentation on theme: "High-Dose Isosorbide Dinitrate for Myocardial Revascularization With Composite Arterial Grafts  Jacob Gurevitch, MD, Hylton I Miller, MB, Itzhak Shapira,"— Presentation transcript:

1 High-Dose Isosorbide Dinitrate for Myocardial Revascularization With Composite Arterial Grafts 
Jacob Gurevitch, MD, Hylton I Miller, MB, Itzhak Shapira, MD, Amir Kramer, MD, Yosef Paz, MD, Menachem Matsa, MD, Rephael Mohr, MD, Vladimir Yakirevich, MD  The Annals of Thoracic Surgery  Volume 63, Issue 2, Pages (February 1997) DOI: /S (96)00923-X

2 Fig. 1 (A) Composite double internal mammary artery (IMA) grafting and (B) angiographic study at 4 weeks. Pediculate left IMA (LIMA) is anastomosed to midportion of left anterior descending coronary artery (LAD). Free right IMA (RIMA) graft (proximally attached to LIMA) goes sequentially to two marginal branches (M2, arrows) and continues to right posterior descending coronary artery (RPD). (D1 = first diagonal branch.) The Annals of Thoracic Surgery  , DOI: ( /S (96)00923-X)

3 Fig. 2 (A) Complete arterial revascularization using both internal mammary arteries (IMA) and composite inferior epigastric artery (IEA) and (B) angiographic study at 14 days. Composite IEA [distally grafted to marginal branch (M2)] is attached to in situ left IMA (LIMA) [distally grafted to left anterior descending coronary artery (LAD)]. (Ao = aorta; PA = pulmonary artery; RIMA = right internal mammary artery.) The Annals of Thoracic Surgery  , DOI: ( /S (96)00923-X)

4 Fig. 3 (A) Composite radial artery (RA) grafting to left internal mammary artery (LIMA) and (B) angiographic study at 23 days. The LIMA is distally attached to left anterior descending coronary artery (LAD, thin arrow), and the RA is sequentially grafted to marginal circumflex (M2, upper arrowhead) and right posterior descending coronary (lower arrowhead) arteries. (Ao = aorta, PA = pulmonary artery.) The Annals of Thoracic Surgery  , DOI: ( /S (96)00923-X)


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