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The Annals of Thoracic Surgery, Vol 47, 421-427, Copyright © 1989 by The Society of Thoracic Surgeons
TJ Vander Salm, S Chowdhary, ON Okike, AT Pezzella and MK Pasque
Inadequate length can limit the use of the internal mammary artery (IMA)
for coronary revascularization. By following the shortest route from its
origin to the recipient coronary artery, IMA use can be maximized. Seven
cadavers were studied to determine that shortest route for the left and
right IMAs. The shortest route for the left IMA to the left anterior
descending coronary, diagonal, and circumflex coronary arteries was through
the pericardium (p less than or equal to 0.01). For the right IMA, the
significantly shortest routes were across the anterior heart for the left
anterior descending and diagonal arteries, through the right pericardium
for the right coronary artery or posterior descending artery, and through
the pericardium and transverse sinus for the circumflex artery. Thus, any
coronary artery can be reached with an in situ IMA, and the route through
the pericardium is markedly shorter to ipsilateral coronary arteries.
ARTICLES
Internal mammary artery grafts: the shortest route to the coronary arteries
University of Massachusetts Medical Center, Worcester 01655.
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