Double Internal Mammary Grafting

A four-year experience with 50 patients who underwent coronary re vascularization with bilateral inter nal mammary artery (IMA) and supplemental saphenous vein grafts is presented. A total of 175 grafts were performed (3.2 per patient). All IMA grafts were used in situ. In 12 patients, the right IMA was placed through the transverse sinus to revas cularize the circumflex artery and the left IMA was placed to the LAD. In the remaining 38 patients, both IMAs were used to revascularize the LAD and RCA. No hospital deaths occurred. There were no sternal in fections. Postoperative complications included reexploration for bleeding (2) and diaphragmatic dysfunction (1). Late follow-up was completed in all patients. Forty-five of those fol lowed up for between six months and three and a half years were asympto matic. Exercise stress tests were per formed in 47 patients. The test results were negative in 45 patients and positive in 2. The authors conclude that bilat eral IMA grafting can be accom plished with low operative risk while providing excellent long-term results.