Objective: The various techniques of radial artery (RA) harvesting produce similar results. These techniques use electrocautery, ultrasonic scalpel or sharp scissors in different combinations, but usually involve the use of hemostatic clips. We describe a RA harvesting technique with the combination of sharp scissors and electrocautery without the use of hemostatic clips.Methods: We describe a retrospective study of 107 patients between 28 and 78 years (mean age ranged from 53.3 ± 8 years). Bleeding, re-operation, infarct and death were analyzed. Results:No bleeding was imputed to the RA, and no reoperations were required. There were three (2.8%) infarcts possibly related to the RA anastomosis territory. Mortality was 0.9%, but unrelated to cardiac complications.Conclusion: RA electrocautery harvesting without hemostatic clips presented no bleeding and was an inexpensive procedure, requiring no investments in additional equipment.Descriptors: Radial artery. Myocardial revascularization. Myocardial ischemia. Coronary disease. Rev Bras Cir Cardiovasc 2008; 23(1): 114-117 115 OLIVEIRA, JB ET AL -Radial artery harvesting technique without hemostatic clips and clinical experience

Análise angiográfica tardia dos enxertos empregados na revascularização miocárdica de pacientes com retorno de sintomasCABG late angiographic grafting patency analysis in patients with recurrent symptoms Abstract Objective: Left internal thoracic artery (LITA) grafting has become essential in coronary artery bypass graft procedure (CABG). In order to optimize the use of LITA or other grats, sequential anastomosis has been used. There is no consensus on equivalence between isolated versus sequential grafts. The aim of this study is to compare isolated versus sequential grafts.Methods: From a retrospective patency analysis of the grafts used in 88 symptomatic patients who underwent CABG procedure in our Service was performed through cinecoronariography. Statistical analysis was performed through Student's t test. Each distal anastomosis was considered an independent graft.Results: The mean postoperative period was of 53 + 138 months and mean age was 64 + 11 years. LITA isolated grafts presented patency rate significantly higher than the sequential grafts, respectively 92% (46/50) and 77% (30/39) P = 0.02. However, in injured coronary arteries of > 70%, isolated LITA patency rate was similar to sequential grafts, (95%; 37/39) and (93%; 26/28) respectively; P = 0.37. Mean radial artery patency rate was similar to isolated 71% (5/7) and sequential 90% (19/21) grafts; P = 0. Saphenous veinThis study was carried out at the Paulo Sacramento Hospital. patency rates were similar for isolated 72% (31/43) and sequential 81% (73/90) grafts; P = 0.12. There was no difference between radial artery and saphenous vein patency rates.Conclusion: In symptomatic patients, isolated LITA patency is superior than sequential LITA. However, in coronary injuries of > 70%, the isolated and sequential patency rates are similar. Sequential grafts from radial artery and saphenous vein are similar to their respective isolated grafts. Descriptors: Radial artery. Mammary arteries. Saphenous vein. Coronary disease/surgery. Myocardial revascularization. Resumo Objetivo: A Artéria Torácica Interna Esquerda (ATIE) é o padrão ouro como enxerto na revascularização miocárdica (RM). Para otimizar seu uso, e de outros enxertos, têm sido usadas anastomoses sequenciais. Não há consenso da equivalência dos resultados entre enxertos isolados e sequenciais. O objetivo é comparar a perviabilidade dos enxertos isolados versus sequenciais. 139ROCHA E SILVA, R ET AL -CABG late angiographic grafting patency analysis in patients with recurrent symptoms Bras Cir Cardiovasc 2009; 24(2): 138-142 Rev

SUMMARYDuring coronary artery bypass graft (CABG) surgery, the saphenous vein is sutured through its proximal segment to the aorta. Intimal hyperplasia is one of the possible causes of graft occlusion. Notably, blood turbulence can induce wall shear stress that may also play an important role in this process.OBJECTIVEWe propose a new technique for performing proximal anastomosis to avoid CABG failure.METHODAn 80 kg pig was subjected to open heart surgery. Four stitches were placed in the anterior ascending aorta, which formed a 2 cm by 4 cm patch. This patch was isolated through the application of a tangential clamp that was oriented parallel to the axis of the aorta. After releasing the patch, which was held to the aorta through its cranial end pedicle, the rims were sutured to each other creating a conduit with a length of 4 cm and an internal diameter of 4 mm. The rest of the aortotomy was closed by placing a direct suture between its rims.RESULTThis novel technique created an “in situ” aortic wall graft that was 4 cm long and characterized as being of uniform 4 mm caliber.