Work

An Elegant Approach for Complete Revascularization of the Circumflex Territory

Year: 2026

Type: article

Abstract: Background and Clinical Significance: Revascularization of the circumflex territory remains technically challenging because of its anatomical position and the frequent need for distal branch grafting. Case presentation: We report the case of a 76-year-old man in whom the proximal circumflex trunk was used as the target for an in situ right internal thoracic artery routed through the transverse sinus during combined coronary and ascending aortic surgery. This approach allowed antegrade perfusion of the circumflex territory while avoiding multiple distal anastomoses. In this selected anatomical setting, the technique proved feasible and was associated with excellent intraoperative flow and 1-year radiological patency. Conclusions: Direct grafting of the circumflex trunk is not a new concept, but this case revisits it using a contemporary total arterial revascularization strategy. This approach may represent a useful adjunctive option in carefully selected patients with favorable circumflex anatomy.

Source: Reports — Medical Cases Images and Videos

DOI: 10.3390/reports9020134

Authors: Ziyad Gunga, Mario Verdugo-Merchese, Matthias Kirsch, René Prêtre

Institution: Centre Hospitalier Universitaire Vaudois

Language: English

Topic: Cardiac and Coronary Surgery Techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,689