The internal mammary artery graft. Its longevity after coronary bypass

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Abstract
Patients (298) who received internal mammary artery (IMA) grafts were reviewed 7-9 yr after surgery; 91.6% of these patients are still alive. In 29.5% of these patients there was postoperative graft visualization, and 90% of the studies were performed because of suspected graft failure. Attrition of the IMA graft was minimal. At 0-24 mo. after surgery, 93.4% of grafts were patent. At 60-108 mo., 94.4% were patent and there was little, if any, evidence of atherosclerosis in the IMA. Precise technique in preparation and anastomosis of the IMA is essential for long-term patency. For bypassing obstructive lesions, selection of the IMA (if it has sufficient size and flow) for use in the left anterior descending, large diagonal or marginal vessel in the left coronary artery circulation is recommended.