[HSF] PCI Vs CABG - not all about evidence

[Tohru Asai]

> I would choose LIMA to LAD and good quality SVG to RCA.  I am
> worried about recurrent disease or some other process requiring re-
> sternotomy.  In my hands, re-entry is easier with SVG to RCA than RIMA.
I agree with Ed to choose SVG to RCA. RIMA mostly reaches distal RCA rarely
to PDA. Thin distal end of RIMA is known to prone to be spastic sometime and
I don't like to put RIMA into distal RCA, often thickened walled vessel even
though angiographic lumnal size is adequate. If RCA is large, somehow
ectatic,and with only 70% stenosis, I would never put RIMA. Radial and GEA
also are not promising. Good vein to proximal PDA is my answer,
However I don't understand what problem will occur when RIMA connected to
RCA. It usually off the center. We can make RIMA off sternum.
-- 
Tohru Asai