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Coronary Artery Bypass Grafting Via Transdiaphragmatic Approach: A Report of Ten Cases

The transdiaphragmatic approach with in-situ right gastroepiploic artery graft enables us to perform coronary artery bypass grafting (CABG) without median sternotomy or cardiopulmonary bypass. Ten patients underwent CABG via this approach and were analyzed retrospectively. In all cases, the distal right coronary artery was the target site, and the procedures were completed without intraoperative conversion to median sternotomy or cardiopulmonary bypass. Postoperative coronary angiography demonstrated that all the grafts were patent. Percutaneous coronary artery intervention has been widely performed in recent years, however, this procedure is useful in those patients unsuitable for PCI or which repeatedly develop post PCI restenosis. (J Jpn Coll Angiol 2018; 58 : 181–185)