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Updated: Mar 11, 2026
Human Internal Mammary Artery IMA Transplantation and Stenting: A Human Model to Study the Development of In-Stent Restenosis
Published on: May 9, 2012
[Bilateral Internal Mammary Artery Versus Single Internal Mammary Artery in Myocardial Revascularization Surgery.
Francisca Saraiva1, Noélia Vilas Boas, Mário Jorge Amorim
1Departamentos de Fisiologia e Cirurgia Cardiotorácica da Faculdade de Medicina da Universidade do Porto e Serviço de Cirurgia Cardiotorácica do Centro Hospitalar São João, Portugal.
Background:
Although arterial grafts are superior to venous grafts in terms of long-term patency, single internal mammary artery (SIMA) is still the preferred strategy in most cardiac surgical centres. Our main aim was to compare long- -term survival between BIMA and SIMA at our own tertiary care centre.
Methods:
Retrospective cohort including patients referred to Centro Hospitalar São João (CHSJ), from 2004 to 2011, who underwent isolated CABG and received two or more bypass with at least 1 IMA graft. Kaplan-Meier, Cox regression and propensity score matching 2:1 were used to compare long-term survival between BIMA and SIMA.
Results:
BIMA was performed in 696 (29.3%) out of 2329 eligible procedures. Mean follow-up time was 5.1 years (2-9.9 years). All-cause mortality was superior in patients with only one internal mammary artery - cumulative survival of 75% for SIMA vs 88% for BIMA. Because of discrepancy between groups regarding preoperative and surgical characteristics, we ran a propensity score matching which revealed BIMA as an independent predictor of survival (n=1510, 40.3% BIMA, HR: 0.648, 95% CI: 0.452-0.927).
Conclusion:
BIMA is associated with significantly better long-term survival than SIMA in CABG. A higher sample size might clarify BIMA advantages, discriminating specific groups that might profit the most with this approach.
