How to Tailor A “π” Graft for Complex Myocardial Revascularization: A Variant of the Mammary Loop Technique Lucian Stoica, MD, PhD, Sidney Chocron, MD,

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How to Tailor A “π” Graft for Complex Myocardial Revascularization: A Variant of the Mammary Loop Technique Lucian Stoica, MD, PhD, Sidney Chocron, MD, PhD, Pierre-Emmanuel Falcoz, MD, Djamel Kaili, MD, Joseph-Philippe Etievent, MD The Annals of Thoracic Surgery Volume 79, Issue 3, Pages 1068-1069 (March 2005) DOI: 10.1016/j.athoracsur.2003.12.034

Fig 1 The construction of the “π” graft. (Left) The “Y” graft: (1) the left internal thoracic artery (ITA); (2) the right ITA; and (3) the “Y” anastomosis at the level of the pericardial reflection on the pulmonary trunk. (Middle) The “Y” and the mammary loop: (4) loop anastomosis at a variable level on the right ITA; (5) the loop will be cut open at the appropriate level. (Right) The “π” graft: (6) the left branch made with the left ITA, going to the left anterior descending artery; (7) the middle branch made with the reversed left ITA going to the lateral ventricular wall vessel(s); and (8) the right branch made with the right ITA going to the right coronary artery territory. The Annals of Thoracic Surgery 2005 79, 1068-1069DOI: (10.1016/j.athoracsur.2003.12.034)

Fig 2 (Left) A drawing of the “π” graft construction. (Right) The “π” graft after coronary anastomoses (numbers are defined in Fig 1). The Annals of Thoracic Surgery 2005 79, 1068-1069DOI: (10.1016/j.athoracsur.2003.12.034)

Fig 3 Angiographic assessment of the whole construction (numbers are defined in Fig 1). The Annals of Thoracic Surgery 2005 79, 1068-1069DOI: (10.1016/j.athoracsur.2003.12.034)