Total arterial anaortic off-pump coronary artery bypass grafting for diffuse coronary disease – A case report

Surgical treatment of diffuse coronary artery disease remains challenging. We present here a diabetic patient, with diffuse coronary disease, revascularized using total arterial anaortic off-pump coronary artery bypass grafting. He received total nine distal grafts. He continues to be asymptomatic after more than 2 years. CT angiography follow-up shows eight out of nine grafts are patent. Anaortic off-pump coronary artery bypass grafting has the least incidence of stroke and arterial grafts have the best long-term patency rate. This is the first case report of nine arterial bypass graft performed off-pump using both internal mammary and both radial arteries. Anaortic total arterial off-pump coronary artery bypass grafting has achieved excellent intermediate term result in this patient of diffuse coronary artery disease.