CABG Anatomy On off pump Conduits

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CABG Anatomy On off pump Conduits
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The Heart
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Human Heart
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The Pericardium
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Coronary Anatomy
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Coronary Angiography
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Normal left coronary
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Normal right coronary
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Left Main stem
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Left Main stem
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Lad and circ lesion
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Lad and circ lesion
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Right lesion
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Right lesion
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How to do a CABG

• On pump
• Cardiopulmonary Bypass
• Cardioplegia
• Off pump

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Cardiopulmonary bypass
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Bypass setup
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Bypass machine
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Cardioplegia
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Off pump
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Video
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Conduits

• LIMA
• RIMA
• BIMA (LIMA and RIMA)
• SVG
• Radial left and right
• Other
• Single or composite

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LIMA

• Gold standard for LAD
• Pedicled or non-pedicled
• Skeletonised or not

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LIMA Harvest
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LIMA
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RIMA

• Prox right or prox circ

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BIMA

• Same indications as LIMA and RIMA
• Sternal wound problems especially if diabetic and
  obese

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SVG

• The usual conduit of choice

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Radial artery
Coronary lesion must be gt 70 stenosed No
difference at 5 years for RCA disease compared to
SVG
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Radial Harvest
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Composite graft - T graft
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Answer

• LIMA and
• SVG / radial / RIMA depending on coronary anatomy
  and patient characteristics

Answer is in the middle