Roberto If TIA is absent, I would simply do aortic non-touch OPCAB (RIMA-LAD, LIMA-Cx, GEA-PDA etc). To keep perfusion pressure greater than 90-100 systolic and to keep heparin at least 24 hours postop.During the operation, INVOS monitor is used to watch any drop of saturation of cerebral blood flow. -- Tohru Asai