Weight No Barrier: Anaortic Off-Pump Total Arterial CABG in a 107-kg Patient

Total arterial, anaortic off-pump coronary artery bypass grafting (OPCABG) is a refined surgical approach that minimizes the risks of cardiopulmonary bypass and aortic manipulation. This case report describes a 44-year-old male with triple vessel coronary artery disease who underwent successful total arterial anaortic OPCABG using in-situ bilateral internal mammary arteries. The left internal mammary artery (LIMA) was used for sequential grafting to obtuse marginal branches (OM1 and OM2), and the right internal mammary artery (RIMA) was grafted to the distal right coronary artery (DRCA). The postoperative course was uneventful, and the patient was discharged on postoperative day 3. This case highlights the safety and efficacy of total arterial anaortic OPCABG in high-risk individuals.