[Bilateral internal mammary artery grafting for a patient with poor left ventricular function]

The patient was a 49-year-old man with triple vessel disease. He had been suffered from inferior and antero-septal myocardial infarctions. His left ventricular ejection fraction was estimated as 17 percents. An exercise thallium myocardial scan revealed the area of septal and inferior reversible ischemia. Bilateral in situ internal mammary artery grafting was done; the left internal mammary artery was anastomosed to the left anterior descending coronary artery and right internal mammary artery to the right coronary artery. Assisted circulation with IABP was required after operation. Post operative course was uneventful, and clinical state was improved.