Abstract
Coronary bypass grafts using the internal mammary artery usually have an excellent record of success and long term patency. We report a 42 year old man who initially presented with a history of atypical left sided chest pain, who had coronary artery bypass surgery for a severe stenosis in his proximal left anterior descending coronary artery (LAD) and moderate stenosis of his proximal circumflex artery, with his LIMA being grafted to his mid-LAD and a saphenous venous graft to the proximal LAD. He subsequently developed multiple stenoses in the LIMA graft which required coronary augioplasty and stenting, on more than one occasion, in view of very rapid restenosis within the LIMA graft. Keywords: graft patency; left internal mammary artery grafts; restenosis; stenosis
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Figure 1 .
Severe stenosis involving the insertion of the left internal mammary artery (LIMA) graft into the left anterior descending coronary artery and the left anterior descending coronary artery itself. Note the severe in-stent restenosis in the proximal portion of the LIMA graft, proximal to several intercostal branches.
Figure 2 .
Post-PTCA, showing patent LIMA graft with good run off but mild residual proximal stenosis.
Figure 3 .
Restenosis in the proximal LIMA stent extending to the ostium of the LIMA, before (left) and after (right) PTCA.
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
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