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In-Situ BITA for the Whole Heart Using OPCAB Technique

Tuesday, November 16, 2021

Tavilla G, Beckles DL, Reddy RC. In-Situ BITA for the Whole Heart Using OPCAB Technique. November 2021. doi:10.25373/ctsnet.17014196

This video presents an off-pump technique to achieve total arterial revascularization in three-vessel disease using exclusively in-situ bilateral mammary arteries.

In the first case, a retro-aortic RITA is used to revascularize the vessels of the anterior wall and a LITA is used for the vessels of the lateral and posterior walls.

In the second case, where on the anterior wall only the LAD must be revascularized, the RITA is routed in front of the aorta to reach the LAD. The LITA is simultaneously used for the lateral and posterior wall.


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Good clean technique - thanks for sharing Please elaborate on your technique for lifting the heart with the tape gauze you have shown What has been your experience with LITA RITA Y technique ?
Congratulation to all the surgeons who have adopted the presented method of off pump TAR so long had been proposed from the end of the last century (D. Taggart).However, looking at the recent years' statistics, regretfully this form of coronary revascularization has still remained low (5-6 %)-though one should consider it mandatory- based upon the research related to the nitric oxide production of the IMA,which certainly preserve the recipient artery endothelial function, etc. One technical note to the author, one should avoid to use metal clip on the IMA until the anastomosis will have been completed (damages the endothelium) -plastic clip with less gripping force is advisable with periodical release to flush blood for nutrition of the artery IMA).
Really creative! Thank you for giving me another way to think about grafting! I like the RIMA through transverse sinus to make re-do's less stressful, and then having full length of LIMA for the lateral wall. Do you worry about the angle of LIMA to that PDA? Part of me is worried about kinking. Thank you!

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