sequential anastomosis
Grafting technique using one conduit to bypass multiple coronary vessels through side-to-side and end-to-side connections.
Full Definition
A coronary revascularization technique that uses a single arterial or venous conduit to create multiple bypasses to different coronary vessels or different segments of the same vessel. This approach typically involves creating side-to-side anastomoses to proximal vessels followed by an end-to-side anastomosis to the most distal target vessel. Sequential grafting maximizes the use of available conduit length, particularly important when using arterial grafts like the internal mammary artery or radial artery. The technique is commonly employed in multivessel coronary artery disease to achieve complete revascularization while minimizing the number of conduits required. Sequential anastomosis can improve graft flow dynamics and may provide better long-term patency rates compared to individual grafts. However, it requires careful attention to conduit geometry to prevent kinking or tension, and failure of the conduit affects all downstream targets.
Usage
Usage note: Specify the order of anastomoses (side-to-side then end-to-side) and target vessels in operative notes.
In Context
- "Sequential anastomosis of the LIMA to the LAD and diagonal branch was performed to achieve complete revascularization." — operative report
- "The surgeon chose sequential anastomosis to maximize the use of the limited radial artery length." — surgical technique note