Y configuration of the internal thoracic arteries in myocardial revascularization.

This paper describes the short-term results of surgical myocardial revascularization in 35 patients. Y configuration from one or two internal thoracic arteries was applied for bypass grafting of the left coronary artery. In 4 patients with truncal stenosis of the left coronary artery (LCA) or proximal stenoses of the anterior interventricular artery (AIVA) and circumflex artery, the length of the left internal thoracic artery (LITA) appeared adequate for creation of Y bypass and revascularization of the entire LCA pool. In most cases (28), Y bypass was formed from both ITA, which made it possible to revascularise more distant arteries of the posterolateral wall of the left ventricle. Analysis of bypass-graphies performed in 10 patients after 7 months on the average has demonstrated that occlusion (2) and stenosis of one of the branches (2) of Y bypass were most probably caused by underestimation of the degree of stenosis of the target coronary arteries.