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Noel L. Mills
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Ann Thorac Surg 1977;23:118-121
© 1977 The Society of Thoracic Surgeons

Articles

Long-Term Follow-up of Internal Mammary Artery Myocardial Implantation

John L. Ochsner, M.D.*, Patterson W. Moseley, M.D., Noel L. Mills, M.D., P. Jeffrey Bower, M.D.

Accepted for publication June 28, 1976.

* Address reprint requests to Dr. John Ochsner, Ochsner Clinic, 1514 Jefferson Hwy, New Orleans, LA 70121.

A study was made of 100 patients who had undergone internal mammary artery myocardial implantation 7 to 10 years previously. Forty-two patients had single implantation with or without a free omental graft, and 54 received double implantations. Four patients had a single internal mammary artery implant plus a single aortocoronary bypass graft. Eleven patients died at operation or within the first month, and 17 died from 1 to 7 years following operation. Two were lost to follow-up, and 15 refused follow-up angiograms.

From 7 to 10 years postoperatively, angiographic studies were performed on 55 patients with 73 internal mammary artery implants. Of these 73 implants, 17 (23%) were occluded; 10 (14%) were patent but did not show myocardial filling; 15 (21%) showed myocardial blush or filling of small vessels; and 31 (42%) showed filling of a major coronary artery. The patency rate correlated well with the amount of coronary disease and slightly with the amount of symptomatic improvement.

This study shows that the Vineberg operation is physiologically sound; however, the ideal candidates are those patients with coronary arteries of adequate size who could benefit more by direct perfusion.




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