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Ann Thorac Surg 1980;29:234-242
© 1980 The Society of Thoracic Surgeons

Articles

Long-Term Results of Internal Mammary Artery Implantation for Coronary Artery Disease: A Controlled Trial

J.N. Bhayana, M.D., Andrew A. Gage, M.D., Timothy Takaro, M.D.* By the Participants of the Veterans Administration Coronary Bypass Surgery Cooperative Study Group

From the Buffalo Veterans Administration Medical Center, Buffalo, NY, and the Veterans Administration Medical Center, Asheville, NC

Accepted for publication August 20, 1979.

* Address reprint requests to Dr. Takaro, Veterans Administration Medical Center, Asheville, NC 28805

One hundred forty-six adult men from sixteen Veterans Administration hospitals were entered in a controlled prospective clinical trial. Seventy-one patients were randomly allocated to receive implantation of the internal mammary artery into the left ventricular myocardium for chronic ischemic heart disease with angina pectoris, and 75 were assigned to the control group. The two treatment groups were similar at baseline with respect to sixteen clinical and angiographic factors thought to have prognostic importance. Most of the patients were operated on before 1970.

Operative mortality was 12%, and implant patency in 52% of eligible patients studied 1 year after operation was 67%. At the end of follow-up extending up to 12 years (mean, 9.3 years), cumulative survival for both groups was similar. Over half of the patients (58%) had died at the end of 10 years (5% per year).

While the hypothesis on which the operation was based appears to be valid, the degree of revascularization achievable in most patients did not affect longevity.




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