Aorta-circumflex coronary artery bypass through the transverse sinus. A new technique.

Aorta-circumflex coronary artery bypass using a saphenous vein graft may present technical inadequacies with angulation, kinking, compression, tension and finally thrombosis and occlusion of the graft. As these problems are mainly secondary to incorrect length and direction of the vein graft, a new technique is described which allows the placement of a shorter graft in a more parallel direction to the physiologic aortocoronary flow. The transverse sinus of the heart is used as a natural protected channel whereby the graft passes behind the great vessels from the right posterior wall of the aorta to the circumflex coronary artery. Thus, redundancy, angulation and kinking are avoided and flow in the graft takes a more natural course.