Off-pump, total arterial coronary artery bypass grafting (CABG) is a technically demanding myocardial revascularization strategy that combines the long-term benefits of multi-arterial CABG with a no-touch aortic technique. Dedicated training and mentoring are essential in order to learn how to successfully perform this challenging surgical procedure. In this video-tutorial, we present a complete step-by-step approach to safely reproduce this procedure. We will cover the harvesting techniques adopted for internal mammary arteries (ITAs) and for the radial artery (RA), and the several options to construct and deploy multi-arterial composite grafts ("T/Y", "K", and "I" grafts), with a focus on minimizing aortic manipulation.
© The Author 2016. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.