J.Jpn. Surg. Soc.. 87(9): 1009-1012, 1986

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Report on the annual meeting

RESULTS OF INTERNAL MAMMARY ARTERY-CORONARY ARTERY BYPASS SURGERY AND THE CHARACTERISTICS OF INTERNAL MAMMARY ARTERY GRAFTS

Coronary artery bypass grafting utilizing an internal mammary artery (IMA) was performed in 108 patients with operative mortality (＜1 month) of 0% and hospital mortality of 1.9%. Postoperative clinical, electrocardiographic, isotopic, angiographic and coronary sinus flow-metric studies all have demonstrated that an IMA can respond well to myocardial blood flow demand both at rest and during exercise, resulting in excellent clinical improvements. In addition, no signs of ischemia were detected in 15 patients with a stenosis in the left main trunk treated with an IMA graft.
Postoperative angiography performed in 60 unselected patients (average 3 months after surgery) showed the IMA patency rate of 98% in comparison with 88% patency in SVGs to the LAD (p＜0.05). Not only the patency rate, but also the graft wall characteristics were much better in IMA grafts than in SVGs. Postoperative changes in the IMA graft caliber and the low rate of progression of stenosis in the native recipient coronary artery receiving an IMA graft have led us to conclude that the IMA graft is a “living conduit” and a very large collateral vessel created by surgery；thus responding well to coronary blood flow demand in the cooperative fashion to native coronary flow.

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