Off-pump grafting of the main circumflex coronary artery in the atrioventricular groove via sternotomy

Background. We report our off-pump technique for grafting of the main circumflex coronary artery in the atrioventricular groove performed through a median sternotomy. Methods. Six patients with significant proximal stenoses of the circumflex coronary presented with small obtuse marginal branches. In each case, three-vessel coronary artery disease was present requiring median sternotomy. Each patient underwent off-pump grafting of the main circumflex coronary artery in the atrioventricular groove. Hemodynamic indicators were recorded every 60 seconds. Results. In all six cases, the main circumflex coronary artery was bypassed using off-pump techniques. There was no significant hemodynamic compromise during the procedure and all patients did well postoperatively. Follow-up stress echocardiography and angiography was obtained. Conclusions. Grafting of the main circumflex coronary artery in the atrioventricular groove can be successfully and safely performed off pump through a median sternotomy.