This 80 yr old lady had a "Y" graft CABG procedure performed using an Octopus technique with a vein graft to Cx and radial to PDA. This angiogram taken in the LAO projection (click here to download the actual angiogram [.avi- 8Mb]) taken one month after the octopus procedure demonstrated a blocked osteum (A). Upon catheterising the native left coronary, it was found that the contrast flowed via the native Cx (90% stenosis)--> Vein graft --> Radial graft --> PDA.

Click here to download the RAO projection[.avi-8Mb].

Interestingly the valve in the vein graft (B) did not completely obstruct the retrograde flow as can be seen in other cases where the vein grafts have been accidently inserted upside down.

9 months later this elderly lady recieved a stent to her proximal Cx.