Use of internal mammary artery in radiation-induced coronary artery disease

In 3 patients who had been subjected to mediastinal irradiation for breast cancer, the internal mammary artery was used as a conduit for myocardial revascularization. Intraoperatively, in all patients the internal mammary artery exhibited excellent blood flow and except for mild adhesions between the pericardium and epicardium no unusual technical problems were encountered. Preoperative assessment of the internal mammary artery by angiography is recommended in patients with radiation-induced coronary artery disease who are scheduled to undergo myocardial revascularization with intended use of the internal mammary artery.