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[Coronary bypass with arteries]
1Klinik für Herz- und Gefässchirurgie am Herz- und Kreislaufzentrum Rotenburg a.d.F.
The internal mammary artery (IMA) and the right gastroepiploic artery are increasingly used for myocardial revascularization. The postoperative results are much better than those of the saphenous vein regarding mortality, patency rate, and relief of symptoms. The IMA can be used as an in-situ-graft or as a free transplant, either as a single graft or using sequential anastomoses. Ten years postoperative 90% of the IMA-bypasses are patent and risk of reoperation is significantly lower in patients with IMA-grafts. From August 10, 1989 until January 31, 1991, 1515 patients were operated for coronary artery disease in our center. There were 1219 men and 296 woman with a mean age of 58.9 years (26-83 years). In 1050 patients (69.3%), either one or both IMA-arteries were used. 75% of the men and 47.7% of the women received an IMA-graft. 981 patients had an in-situ-graft, and in 69 patients the IMA was used as a free transplant. In 74 cases both IMAs were used. In 315 patients sequential anastomoses with one IMA and several coronary arteries were performed. According to our experience, the IMA is an ideal bypass conduit and should be used predominantly.
The internal mammary artery (IMA) and the right gastroepiploic artery are increasingly used for myocardial revascularization. The postoperative results are much better than those of the saphenous vein regarding mortality, patency rate, and relief of symptoms. The IMA can be used as an in-situ-graft or as a free transplant, either as a single graft or using sequential anastomoses. Ten years postoperative 90% of the IMA-bypasses are patent and risk of reoperation is significantly lower in patients with IMA-grafts. From August 10, 1989 until January 31, 1991, 1515 patients were operated for coronary artery disease in our center. There were 1219 men and 296 woman with a mean age of 58.9 years (26-83 years). In 1050 patients (69.3%), either one or both IMA-arteries were used. 75% of the men and 47.7% of the women received an IMA-graft. 981 patients had an in-situ-graft, and in 69 patients the IMA was used as a free transplant. In 74 cases both IMAs were used. In 315 patients sequential anastomoses with one IMA and several coronary arteries were performed. According to our experience, the IMA is an ideal bypass conduit and should be used predominantly.