Internal Mammary and Coronary Artery Suture- Anastomosis With Use of Patch Grafting

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Abstract
The internal mammary artery was sutured end-to-end to the distal stump of the ligated and transected circumflex branch of the left coronary artery in dogs. Short longitudinal incisions were made in the anterior wall of both vessels, starting at the point of transection. To enlarge the anastomosis, the defect caused by the incisions was repaired with an autologous patch graft. During almost the entire procedure, coronary circulation was maintained by a temporary internal shunt. While results up to two months postoperatively were excellent, the anastomosis showed a strong tendency toward late occlusion. This phenomenon was attributed to reduction of flow due to extensive periarterial scar tissue formation, rather than to real thrombosis starting at the suture line itself.

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