The Atrium: Proximal Coronary Anastomosis

In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. John Puskas, professor of surgery at Emory University, Chief of Cardiothoracic Surgery at Emory University Hospital Midtown, and Wilton Looney Director at the Emory Carlyle Fraser Heart Center in Atlanta, Georgia, USA, about proximal coronary anastomosis.

Chapters

00:00 Intro

00:44 About Dr. Puskas

03:35 Background & History

06:56 10 Commandments for PA

10:34 When to Do It?

13:57 Aorta Site Selection

19:32 Step-by-Step

29:21 Sewing Onto Aorta

33:15 Variations & Alternatives

44:50 Key Messages

46:08 Advice to Trainees

They discuss the 10 principles for proximal anastomosis during coronary artery bypass grafting, saphenous vein grafts vs free arterial grafts, as well as the optimal site selection on the aorta. They also explored key aspects of preparation and arteriotomy, and highlighted various variations and alternatives, such as clampless techniques and sequential grafting. Additionally, they examined the pitfalls and complications associated with proximal coronary anastomosis and the future of proximal coronary anastomosis.   

The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Watch for next month’s episode on extended resection with Dr. Erinoangelo Rendina.  

Related Resources  

1. The 10 Commandments for Proximal Anastomosis During CABG: Techniques and Technologies for Vein and Arterial Grafts  

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