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The Journal of Thoracic and Cardiovascular Surgery, Vol 91, 9-16, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
AJ Tector, TM Schmahl and VR Canino
To improve the early and late benefits from coronary artery bypass
grafting, we have expanded the use of the internal mammary artery by
bypassing three or more coronary arteries with mammary grafts. Experience
with higher power magnification and the use of the single internal mammary
artery are necessary prerequisites of this procedure. The first 100
patients who had three or more mammary artery-coronary artery anastomoses
are reviewed. Eighty-six patients received three mammary-coronary
anastomoses, 13 received four, and one received six. An average of 3.2
internal mammary artery grafts and 1.7 saphenous vein grafts per patient
were placed. Twenty-five of 27 mammary grafts were open on postoperative
graft visualization. There were no early deaths and only one patient died
late of complications of gangrene of the lower extremities. None of the
patients had significant left ventricular failure and only three had
perioperative myocardial infarctions. None of the patients complain of
angina and 58 of 59 postoperative stress tests were normal. This procedure
should significantly reduce the late closure of bypass grafts and the
complications thereof, including the need for reoperation.
ARTICLES
Expanding the use of the internal mammary artery to improve patency in coronary artery bypass grafting
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