In this series of surgical videos by Professor Tristan Yan from the Royal Prince Alfred Hospital in Sydney, Australia, he demonstrates essential techniques of total arterial anaortic off-pump bypass grafting, using the left internal mammary artery and left radial artery to achieve complete surgical revascularization.
In this video, he rotates the heart toward the right chest and then places an octopus evolution tissue stabilizer to expose the obtuse marginal artery. He then places the radial artery that has previously been anastomosed in an end-to-side fashion to the LIMA on a swab in the atrial-ventricular groove in preparation for a side-to-side anastomosis. A silastic sling is then passed around the proximal obtuse marginal artery. After arteriotomy, a small silastic shunt is placed into the lumen of the obtuse marginal artery to protect the back wall. Of note, the surgeon also demonstrates ambidextrous suturing technique to facilitate his particular placement of every suture. At the end of the anastomosis, the bulldog is removed from the radial artery and the lateral wall is perfused.
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