Background: Despite extra length obtained by skeletonized harvesting, right internal thoracic artery (RITA) length remains the main limiting factor for applying in-situ left-sided bilateral ITA (BITA) configurations. We aimed to delineate morphological or demographical patients' descriptors predicting eligibility to undergo retroaortic RITA (rRITA) grafting, i.e., rRITA ability to reach the target circumflex artery (Cx)-branch.
Methods: 861 consecutive patients undergoing skeletonized BITA grafting (2006-2011) were categorized by the configuration, rRITA (n=300) or T-grafts. Morphological and demographical patient's characteristics were analyzed and rRITA Cx-target was recorded.
Results: LOESS curves created by logistic regression model have yielded a correlation between patient-height and the likelihood to undergo rRITA grafting in both genders (Fig. 1). Other morphological or demographical patients' descriptors including weight, body surface area, body mass index, age or gender, had no independent effect on this probability. The distribution of 337 rRITA targets was: M1 (74.5%), M2 (12.4%), ramus (11.2%) and M3 (1.9%); sequential M1-M2 in12.3%. Success-rate in reaching proximal and distal Cx-targets was 97% and 30%, respectively.
Conclusions: Taller patients have higher likelihood to qualify for rRITA grafting irrespective of age or gender. Female patients should be favorably considered, particularly if tall. Favorable short- and long-term outcomes have led us to recommend this BITA configuration whenever technically feasible.
