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The Journal of Thoracic and Cardiovascular Surgery, Vol 86, 697-702, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Sequential internal mammary-coronary artery bypass

SS Kabbani, ES Hanna, TT Bashour, JR Crew and DG Ellertson

Since April, 1977, a total of eight patients have undergone sequential bypass grafting of the internal mammary artery (IMA) to the coronary arteries at our institution. The indication for this newly described procedure was either insufficient supply of adequate veins (four patients) or the presence of a diseased aortic wall (two patients). Operative procedures included left IMA bypass to the left anterior descending (LAD) artery and its major diagonal branch in six patients; to the obtuse marginal branch and distal circumflex artery in one patient; and to two consecutive sites on the LAD in one patient. All patients became angina-free after operation for a follow-up period lasting up to 6 years. Recatheterization studies were performed in four patients, in all of whom the IMA sequential grafts were found patent. We believe that IMA sequential grafting is an important option available to the cardiac surgeon in managing some patients with coronary artery disease.

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