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Ann Thorac Surg 1990;49:1014-1015
© 1990 The Society of Thoracic Surgeons

Articles

Extended use of bilateral internal mammary arteries for coronary artery disease

A.David Slater, MD*, John P. Gott, MD, Laman A. Gray, Jr, MD

Department of Surgery, University of Louisville School of Medicine, and The Jewish Hospital Heart and Lung Institute, Louisville, Kentucky USA

Accepted for publication March 13, 1990.

* Address reprint requests to Dr Slater, Department of Surgery, University of Louisville, 550 South Jackson St, Louisville, KY 40202.

The internal mammary artery is the conduit of choice for coronary artery revascularization. Wide angulation between the left anterior descending coronary artery and obtuse marginal branches and the diseased segments of the coronary arteries can prevent optimal positioning of the left internal mammary artery for sequential anastomoses for revascularization. We describe a technique using a segment of the left internal mammary artery as a free graft sewn in an end-to-side fashion to the in situ left internal mammary artery. This approach has technical and physiological advantages over previously described techniques.




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