If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Coronary Revascularization Center, Cleveland Clinic, Cleveland, OH.
Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Coronary Revascularization Center, Cleveland Clinic, Cleveland, OH.
The authors regret that in the article “Multi-arterial Coronary Grafting” by Rami Akhrass and Faisal G. Bakaeen in the Summer 2022 issue (27(2):126-146, 2022; https://doi.org/10.1053/j.optechstcvs.2021.09.001), (Figures 2 and 10) included an error with the course of the right internal thoracic artery (RITA). The corrected figures are included on the next 2 pages. Figure 2 was used as the cover image for the issue. In both Figures 2 and 10, the RITA should be anterior to the superior vena cava and posterior to the pulmonary artery.
Figure 2In-situ BITA: 2 arterial inflows/transverse sinus: The mainstay of a typical CABG operation includes a LITA-LAD, which the rest of the conduits are planned and built around. Grafting the LITA-LAD first secures the best conduit to the best target, but this might need to be delayed to prevent undue tension on the anastomosis that may occur while exposing a high OM branch. The in-situ RITA is passed through the transverse sinus and used for a high OM. Disadvantages include possible twisting and/or bleeding through the transverse sinus that is difficult to visualize, as well as the inability to reach distal circumflex targets. BITA = bilateral internal thoracic artery; CABG = coronary artery bypass grafting; LITA = left internal thoracic artery; LAD = left anterior descending; OM = obtuse marginal; RA = radial artery; RCA = right coronary artery; RITA = right internal thoracic artery.
Figure 10Composite in-situ RITA/RA: The in-situ LITA-LAD is maintained. The in-situ RITA is extended with RA (end-to-end composite RITA/RA) and used for several targets after passing through the transverse sinus. Two arterial inflows are provided. LITA = left internal thoracic artery; LAD = left anterior descending; OM = obtuse marginal; RA = radial artery; RCA = right coronary artery; RITA = right internal thoracic artery.
Arterial conduits, especially internal thoracic arteries (ITAs), are rarely affected by intimal hyperplasia or atherosclerosis, major contributors to early and late vein graft failure. Improved survival and freedom from reintervention with multi-arterial grafting (MAG) are reported in large observational studies, particularly when more than one anatomically important coronary territory is supplied. Several grafting configurations are possible depending on conduit and target characteristics, with the left ITA to the left anterior descending (LITA-LAD) typically being the cornerstone around which the rest of the conduits are constructed.
00098-8&id=gr2.jpg){kind=link}
00098-8&id=gr10.jpg){kind=link}