Combined Mammaria Interna Artery for Multivessel Coronary Artery Bypass Grafting

Cihat BAKAY, Atıf AKÇEVİN, Kaya SÜZER, Tufan PAKER, Halil TÜRKOĞLU, Belhhan AKPINAR, Aydın AYTAÇ, Cemi DEMİROĞLU

İ.Ü. Kardiyoloji Enstitüsü, Kalp-Damar Cerrahisi Ana Bilim Dalı, Haseki, İstanbul

Five patients with multiple-vessel coronary artery disease underwent isolated coronary artery bypass grafting with a tecnique involving both internal mammary arteries and a small piece of interposed saphenous vein. The combined internal mammary artery grefts were used for seqential grafting. A total of 20 anastomoses were performed (average number, 4 anastomoses per patient). There were no operative deaths. Postoperative complications included reoperation for bleeding in 1 patient and diaphragmatic dysfunction in another. Postoperative coronary angiograhy 2 days before discharge (mean time, 10 days postoperatively) revealed that all the sequential anastomoses with the combined IMA graft were patent. Exercise tolerance tests performed 3 and 11 months postoperatively indicated excellent results and no ischemia. Based on this experience, we conlclude that this method appears promising for multivessel coronary artery bypass grafting.

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