Preparation of the internal mammary artery for coronary artery bypass grafting

The described internal mammary artery (IMA) preparation reduces several shortcomings of the IMA graft procedure. The technique increases vessel diameter through single plane pedicle fascial incision assisted by gentle balloon dilatation. Trauma to the intima from instrumentation is minimized due to the atraumatic nature of a soft air-filled balloon catheter and avoidance of shear forces exceeding 40 g. The increase in vessel diameter effected by balloon dilatation creates a larger hood area to facilitate the distal anastomosis. The technique also maximizes the length of the IMA for sequential grafting.