Thorac Cardiovasc Surg 1984; 32(5): 288-292
DOI: 10.1055/s-2007-1023406
© Georg Thieme Verlag Stuttgart · New York

Sequential Internal Mammary Artery (IMA) Grafts in Coronary Artery Bypass Surgery

P.-T. Harjola1 , M. H. Frick2 , A. Harjula1 , A. Järvinen1 , H. Meurala1 , M. Valle3
  • 1Department of Thoracic and Cardiovascular Surgery,
  • 2First Department of Internal Medicine,
  • 3Institute of Diagnostic Radiology, University Central Hospital, Helsinki, Finland
Further Information

Publication History

1984

Publication Date:
30 April 2008 (online)

Summary

Since 1972, double or triple left IMA bypasses have been made on 61 consecutive patients with a total of 123 distal anastomoses to the LAD or to the LD branches of the LAD. There were 54 additional vein grafts with 102 distal anastomoses. The number of single IMA grafts in the same period of time was 400. Hospital mortality was 2 patients (3.3%), with a late mortality of 7 patients (11.3%), 2 of them being heart-related, one of hypernephroma, one suicide, and of unknown cause in the remaining 3 patients. Five patients refused postoperative angiography. There were 50 patients with one or more postoperative angiograms available for the analysis after a mean follow-up time of 35.1 (0.5 to 128) months.

The late patency of the left IMA anastomoses was 97% (98/101) and 82.4% (84/102) of the vein anastomoses. There were 2 anastomotic left IMA occlusions to the LD at 2 weeks and 10 months, respectively, and to LAD at 13 months. No left IMA graft had become completely occluded. According to the trend analysis, there was a 97.5% patency at 5 years, and 95.7% at 10 years with left IMA grafts compared to 78.4 and 67.9, respectively, with vein grafts. Ten left IMA grafts were dilated, 2 narrowed and 36 unchanged at the late angiography.

Sequential left IMA graft, in appropriate cases seems to result in the most superior patency rate of all types of grafts.