Abstract
Patency rates and long-term clinical results after coronary artery bypass are superior when the internal mammary artery, rather than the saphenous vein, is used as a bypass graft. Four thousand forty-seven cardiac surgeons were surveyed to assess their theoretical preference of bypass graft, in comparison to their actual practice. The 750 surgeons performing myocardial revascularization who completed the questionnaire had done approximately 122,652 coronary artery bypass operations annually. Six hundred twenty-nine (84%) listed the internal mammary artery as the graft of choice for bypassing the left anterior descending coronary artery, whereas 114 (15%) listed the saphenous vein. Only about half (56%) of the surgeons actually used the internal mammary artery commonly, however, and only 228 (30%) used it in at least 90% of their operations. In actual practice, then, the internal mammary artery is often avoided in situations where it could be used as a coronary artery bypass graft. This practice can be expected to have a negative influence on late postoperative results. (The Texas Heart Institute Journal 1987; 14:139-143)
Keywords: Aortocoronary bypass
Keywords: myocardial revascularization
Keywords: internal mammary artery implantation
Keywords: saphenous vein
Full text
PDF




Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Campeau L., Lespérance J., Hermann J., Corbara F., Grondin C. M., Bourassa M. G. Loss of the improvement of angina between 1 and 7 years after aortocoronary bypass surgery: correlations with changes in vein grafts and in coronary arteries. Circulation. 1979 Aug;60(2 Pt 2):1–5. doi: 10.1161/01.cir.60.2.1. [DOI] [PubMed] [Google Scholar]
- Cosgrove D. M., Loop F. D., Lytle B. W., Gill C. C., Golding L. A., Gibson C., Stewart R. W., Taylor P. C., Goormastic M. Predictors of reoperation after myocardial revascularization. J Thorac Cardiovasc Surg. 1986 Nov;92(5):811–821. [PubMed] [Google Scholar]
- Gould B. L., Clayton P. D., Jensen R. L., Liddle H. V. Association between early graft patency and late outcome for patients undergoing artery bypass graft surgery. Circulation. 1984 Mar;69(3):569–576. doi: 10.1161/01.cir.69.3.569. [DOI] [PubMed] [Google Scholar]
- Green G. E., Stertzer S. H., Reppert E. H. Coronary arterial bypass grafts. Ann Thorac Surg. 1968 May;5(5):443–450. doi: 10.1016/s0003-4975(10)66377-1. [DOI] [PubMed] [Google Scholar]
- Grondin C. M. Late results of coronary artery grafting: is there a flag on the field? J Thorac Cardiovasc Surg. 1984 Feb;87(2):161–166. [PubMed] [Google Scholar]
- Johnson A. M., Kron I. L., Watson D. D., Gibson R. S., Nolan S. P. Evaluation of postoperative flow reserve in internal mammary artery bypass grafts. J Thorac Cardiovasc Surg. 1986 Nov;92(5):822–826. [PubMed] [Google Scholar]
- Kamath M. L., Matysik L. S., Schmidt D. H., Smith L. L. Sequential internal mammary artery grafts. Expanded utilization of an ideal conduit. J Thorac Cardiovasc Surg. 1985 Feb;89(2):163–169. [PubMed] [Google Scholar]
- Kolessov V. I. Mammary artery-coronary artery anastomosis as method of treatment for angina pectoris. J Thorac Cardiovasc Surg. 1967 Oct;54(4):535–544. [PubMed] [Google Scholar]
- Loop F. D., Lytle B. W., Cosgrove D. M., Stewart R. W., Goormastic M., Williams G. W., Golding L. A., Gill C. C., Taylor P. C., Sheldon W. C. Influence of the internal-mammary-artery graft on 10-year survival and other cardiac events. N Engl J Med. 1986 Jan 2;314(1):1–6. doi: 10.1056/NEJM198601023140101. [DOI] [PubMed] [Google Scholar]
- Lytle B. W., Kramer J. R., Golding L. R., Cosgrove D. M., Borsh J. A., Goormastic M., Loop F. D. Young adults with coronary atherosclerosis: 10 year results of surgical myocardial revascularization. J Am Coll Cardiol. 1984 Sep;4(3):445–453. doi: 10.1016/s0735-1097(84)80086-8. [DOI] [PubMed] [Google Scholar]
- Lytle B. W., Loop F. D., Cosgrove D. M., Ratliff N. B., Easley K., Taylor P. C. Long-term (5 to 12 years) serial studies of internal mammary artery and saphenous vein coronary bypass grafts. J Thorac Cardiovasc Surg. 1985 Feb;89(2):248–258. [PubMed] [Google Scholar]
- Miller D. W., Hessell E. A., Winterscheid L. C., Merendino K. A., Dillard D. H. Current practice of coronary artery bypass surgery. Results of a national survey. J Thorac Cardiovasc Surg. 1977 Jan;73(1):75–83. [PubMed] [Google Scholar]
- Miller D. W., Jr, Ivey T. D., Bailey W. W., Johnson D. D., Hessel E. A. The practice of coronary artery bypass surgery in 1980. J Thorac Cardiovasc Surg. 1981 Mar;81(3):423–427. [PubMed] [Google Scholar]
- Nkongho A., Luber J. M., Bell-Thomson J., Green G. E. Sternotomy infection after harvesting of the internal mammary artery. J Thorac Cardiovasc Surg. 1984 Nov;88(5 Pt 1):788–789. [PubMed] [Google Scholar]
- Ochsner J. L. Institutional variations influencing results: arterial versus venous grafts. Circulation. 1982 Jun;65(7 Pt 2):81–85. doi: 10.1161/01.cir.65.7.81. [DOI] [PubMed] [Google Scholar]
- Schmidt D. H., Blau F., Hellman C., Grzelak L., Johnson W. D. Isoproterenol-induced flow responses in mammary and vein bypass grafts. J Thorac Cardiovasc Surg. 1980 Sep;80(3):319–326. [PubMed] [Google Scholar]
- Tyras D. H., Barner H. B., Kaiser G. C., Codd J. E., Pennington D. G., Willman V. L. Bypass grafts to the left anterior descending coronary artery: saphenous vein versus internal mammary artery. J Thorac Cardiovasc Surg. 1980 Sep;80(3):327–333. [PubMed] [Google Scholar]
- Vogel J. H., McFadden R. B., Spence R., Jahnke E. J., Jr, Love J. W. Quantitative assessment of myocardial performance and graft patency following coronary bypass with the internal mammary artery. J Thorac Cardiovasc Surg. 1978 Apr;75(4):487–498. [PubMed] [Google Scholar]
- Wright I. S. Editorial: Fulfillment of hereditary longevity. Circulation. 1976 Jul;54(1):1–2. doi: 10.1161/01.cir.54.1.1. [DOI] [PubMed] [Google Scholar]
