In this video we present our technique of total arterial myocardial revascularization using bilateral internal thoracic arteries and the right gastroepiploic artery as in-situ grafts for three-vessel disease. The left internal thoracic artery (LITA) is used as a sequential graft to the diagonal branch (Diag) and the left anterior descending artery (LAD). The right internal thoracic artery (RITA) is routed through the transvers sinus to revascularize the obtuse marginal branch (OM). Finally, the right gastroepiploic artery (GEA) is used for the posterior descending artery (PDA).
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