Sequential Internal mammary Artery Grafting Extended use of a superior Coronary Bypass conduit is it safe

Abstract

use of sequential internal mammary artery (ImA) grafting is a possible method of improving long term patency in patients receiving coronary artery bypass grafts 9 patients had three vessel disease and one each had single vessel and left main trunk and moderate LV dysfunction was seen in 1. Left internal mammary artery was anastomosed side to side to diagonal and end to side to LAD in 8 and 3 patients had sequential IMA grafts placed proximally and distally to left anterior desending in the presence of tight proximal lesion and disease in its midportion. There was no operative death and no evidence of left ventricular failure. None of the patients suffered perioperative myocardial infarction and / or return of angina. All the patients underwent postoperative ETT within 60 days of operation which was normal in all. Graft visualization in 8 out of 11 patients postoperatively showed patent grafts without kinking or narrowing. These findings suggest that sequential IMA grafting in safe and should improve overall long term patency of coronary artery bypass graft. We recommend this procedure particularly for the younger patients.