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Charles B. Huddleston
William S. Stoney
William C. Alford, Jr.
George R. Burrus
David M. Glassford, Jr.
John W. Lea, IV
Michael R. Petracek
Clarence S. Thomas, Jr.
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Ann Thorac Surg 1986;42:543-549
© 1986 The Society of Thoracic Surgeons

Articles

Internal Mammary Artery Grafts: Technical Factors Influencing Patency

Charles B. Huddleston, M.D., William S. Stoney, M.D.*, William C. Alford, Jr., M.D., George R. Burrus, M.D., David M. Glassford, Jr., M.D., John W. Lea, IV, M.D., Michael R. Petracek, M.D., Clarence S. Thomas, Jr., M.D.

From the Division of Cardiac Surgery, St. Thomas Hospital, and the Department of Cardiac and Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN

* Address reprint requests to Dr. Stoney, Suite 501, St. Thomas Medical Building, 4230 Harding Rd, Nashville, TN 37205

Eight hundred fourteen patients with internal mammary artery (IMA) coronary artery bypass grafts have been restudied 961 times with coronary arteriography, primarily to evaluate the patency of the grafts in the setting of symptomatic coronary occlusive disease. Their records were reviewed to assess graft patency as related to the technical aspects of coronary artery bypass surgery. Patency was evaluated using life-table analysis of the data. The method of harvesting the IMA played no role in patency. The left anterior descending coronary artery was the recipient coronary artery with the highest patency rate. The left IMA had a significantly higher patency rate than the right IMA. As a group, the IMAs had a significantly higher patency rate than saphenous vein grafts. However, there was no difference between right IMA grafts and saphenous vein grafts. The mammary artery grafts that remained patent throughout the study had a significantly higher blood flow after bypass than did those that became occluded (43.0 ± 0.9 versus 28.9 ± 1.8 ml/min; p < .001).




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