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STS CABG Surgeon Worksheet V2.9 □Internal Mammary Artery: →□LIMA → □Pedicle □Skeletonized □RIMA → □Pedicle □SkeletonizedReason for No Internal Mammary Used: →□Subclavian stenosis □Previous mediastinal radiation □No (bypassable) LAD disease□Previous cardio or thoracic surgery □Emergent or salvage procedure □Other□Saphenous → Harvest time: Prep time:□Radial → Harvest time: Prep time:Use one column for each diseased vessel and distal interventionABCDEFGHIJConduitVein Graft In Situ LIMAIn Situ RIMAFree IMAComposite artery-veinRadial ArteryOther arteries; HomograftSynthetic graftHarvest TechniqueDirect VisionEndoscopicThoracoscopyCombination TechniqueRobotic AssistBoth endoscopic and direct visionCryopreservedProximal SiteIn Situ MammaryAscending aortaDescending aortaSubclavian arteryInnominate arteryT-graft off SVGT-graft off RadialT-graft off LIMAT-graft off RIMANatural Y vein graftOtherDistal Insertion SiteLeft Main(p)LAD(m)LAD(d)LADDiag 1Diag 2Diag 3CircOM 1OM 2OM 3RamusRCAAcute MarginalPDAPosterior Lateral (PLB)OtherProximalTechniqueSingle Cross ClampPartial Occlusion ClampAnastomotic Assist DeviceNone (isolated in situ mammary)Distal PositionEnd to SideSequential (side to side)EndarterectomyYesNoVein PatchAngioplastyYesNo Aortic Assessment (epiaortic ultrasound or echo): Concentric Calcification Normal Aorta Extensive Intimal Thickening Protruding Atheroma < 5mm Protruding Atheroma ≥ 5m Mobile PlaquesDid Aortic Assessment Alter Operative Plan? Yes No ................
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