Early angiographic and clinical results of branch conduits attached proximally to left internal thoracic arteries.

BACKGROUND We assessed the characteristics of composite branch conduits attached proximally to an in-situ left internal thoracic artery (LITA). METHODS Sixty nine patients underwent coronary artery bypass grafting (CABG) using composite branch conduits. Overall 35 distal LITAs, 4 RITAs, 18 radial artery grafts (RAG), and 13 inferior epigastric artery grafts (IEA) (both the distal LITA and IEA were used in one patient) were used. Clinical and angiographic results were assessed. RESULTS Patency of branch conduit was 97.1% in distal LITAs, 100% in RITAs, 100% in RAGs, and 90.9% in IEAs. All in-situ LITAs were patent. Ten branch conduits exhibited the string sign. The string sign was caused by competitive flow in seven patients. In three of seven patients with competitive flow, the string sign had resolved at one year after operation as the proximal stenosis of the native coronary artery increased in severity. CONCLUSIONS The results of CABG using branch conduits were satisfactory. It is feasible to observe and follow patients with composite grafts exhibiting the string sign in the absence of ischemia.