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  • Title: [Clinical results of sequential and "Y" grafting with the internal mammary artery].
    Author: Masuda T, Tanimoto Y, Kobayashi Y, Hayashi K, Sakata K, Aoki M.
    Journal: Nihon Kyobu Geka Gakkai Zasshi; 1990 Jul; 38(7):1168-71. PubMed ID: 1976714.
    Abstract:
    One hundred and sixty-five patients (125 men, 40 women; age ranged from 40 to 81 years), underwent coronary artery bypass grafting in the 3 years period from 1986 to 1988. The internal mammary artery (IMA) was applied to 125 patients (75.8%). The sequential left IMA grafting to the left anterior descending coronary artery (LAD) and the diagonal branch (Dg) was performed in 9 out of 125 patients. In 3 of 9 patients, the right IMA was simultaneously grafted to the obtuse marginal branch (OM). In situ bilateral IMAs grafting to the LAD and Dg or LAD and OM were used in 13 patients. In three patients, "Y" grafting (the free right IMA was anastomosed to the side of the in situ left IMA) was performed for LAD and Dg. Eighty-one of 82 IMA grafts (99%) were patent about 1 month after operation. Three patients (1.8%) died during hospitalization, one from Low Output Syndrome, two from cerebral infarction. Perioperative complication included myocardial infarction in 5 (3.0%), cerebral infarction in 10 (6.0%). We concluded that the IMA could be applied in multivessel grafting as well as single vessel grafting in severe diffuse coronary artery disease in the Japanese, and the early patency was good even in the sequential and "Y" grafting.
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