HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Acinapura, A. J. Articles by Cunningham, J. N. Search for Related Content PubMed PubMed Citation Articles by Acinapura, A. J. Articles by Cunningham, J. N.

The Annals of Thoracic Surgery, Vol 48, 186-191, Copyright © 1989 by The Society of Thoracic Surgeons

ARTICLES

Internal mammary artery bypass grafting: influence on recurrent angina and survival in 2,100 patients

AJ Acinapura, DM Rose, IJ Jacobowitz, MD Kramer, RR Robertazzi, J Feldman, Z Zisbrod and JN Cunningham
Department of Cardiac Surgery, St. Vincent's Hospital and Medical Center, New York, New York 10011.

Internal mammary artery (IMA) bypass grafting to the anterior descending coronary artery was performed in 2,100 patients between January 1978 and July 1986. The average number of additional saphenous vein grafts (SVGs) per patient was 1.8. During the same period, 1,753 patients underwent coronary artery bypass grafting using an SVG (average number of grafts per patient, 3.2). The average patient age was similar: 62.3 years for IMA grafts and 64.7 years for SVGs. Men constituted two thirds of each group. Left ventricular function was impaired (ejection fraction less than 45%) in 1,071 (51%) of IMA grafts and 847 (48.3%) of SVGs. Other aggregate risk factors, ie, elevated blood pressure, diabetes mellitus, previous myocardial infarction, and congestive heart failure, were similar in each group. Operative results and postoperative mortality of the IMA and SVG patients were comparable. However, the long-term probability of cumulative survival and occlusion-free survival were significantly greater and the probability of recurrent angina and reoperative coronary artery bypass grafting were significantly less in IMA graft patients (p less than 0.015). The relative risk of occlusion in an SVG was 4 to 5 times greater than that of the IMA graft. These data indicate that a patent IMA graft to the anterior descending coronary artery protects against recurrent angina and death from cardiac-related causes, and that the IMA should be the conduit of choice.

This article has been cited by other articles:

				T. Nakamura, A. Azuma, T. Sawada, K. Sakamoto, T. Yamano, H. Yaku, and H. Matsubara Mobile Stenosis in a Left Internal Mammary Artery Graft: A Case Report Angiology, October 1, 2006; 57(5): 643 - 646. [Abstract] [PDF]

				S. Goldman, K. Zadina, T. Moritz, T. Ovitt, G. Sethi, J. G. Copeland, L. Thottapurathu, B. Krasnicka, N. Ellis, R. J. Anderson, et al. Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: Results from a Department of Veterans Affairs Cooperative Study J. Am. Coll. Cardiol., December 7, 2004; 44(11): 2149 - 2156. [Abstract] [Full Text] [PDF]

				M. Fabbrocini, K. Fattouch, G. Camporini, G. DeMicheli, C. Bertucci, P. Cioffi, and D. Mercogliano The descending branch of lateral femoral circumflex artery in arterial CABG: early and midterm results Ann. Thorac. Surg., June 1, 2003; 75(6): 1836 - 1841. [Abstract] [Full Text] [PDF]

				P. Lamm, G. Juchem, P. Weyrich, A. Schutz, and B. Reichart The harmonic scalpel: optimizing the quality of mammary artery bypass grafts Ann. Thorac. Surg., June 1, 2000; 69(6): 1833 - 1835. [Abstract] [Full Text] [PDF]

				L. Gruberg, G. Dangas, R. Mehran, M. K. Hong, R. Waksman, G. S. Mintz, K. M. Kent, A. D. Pichard, L. F. Satler, A. J. Lansky, et al. Percutaneous revascularization of the internal mammary artery graft: short- and long-term outcomes J. Am. Coll. Cardiol., March 15, 2000; 35(4): 944 - 948. [Abstract] [Full Text] [PDF]

				K. A. Eagle, R. A. Guyton, R. Davidoff, G. A. Ewy, J. Fonger, T. J. Gardner, J. P. Gott, H. C. Herrmann, R. A. Marlow, W. C. Nugent, et al. ACC/AHA guidelines for coronary artery bypass graft surgery: A report of the American College of Cardiology/ American Heart Association task force on Practice Guidelines (Committee to revise the 1991 Guidelines for Coronary Artery Bypass Graft Surgery) J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1262 - 1347. [Full Text] [PDF]

				T. M. Sundt III, H. B. Barner, C. J. Camillo, and W. A. Gay Jr Total arterial revascularization with an internal thoracic artery and radial artery T graft Ann. Thorac. Surg., August 1, 1999; 68(2): 399 - 404. [Abstract] [Full Text] [PDF]

				S. Noda and H. B. Barner Arterial conduits Ann. Thorac. Surg., January 1, 1999; 67(1): 285 - 286. [Full Text] [PDF]

				C. C. Canver, V. M. Armstrong, S. D. Cooler, and R. D. Nichols Assessment of Internal Thoracic Artery Vasoreactivity in Response to Sublingual Nitroglycerin Ann. Thorac. Surg., April 1, 1997; 63(4): 1041 - 1043. [Abstract] [Full Text]

				T. Carrel, P. Horber, and M. I. Turina Operation for Two-Vessel Coronary Artery Disease: Midterm Results of Bilateral ITA Grafting Versus Unilateral ITA and Saphenous Vein Grafting Ann. Thorac. Surg., November 1, 1996; 62(5): 1289 - 1294. [Abstract] [Full Text]

				J. G. Grandjean, A. A. Voors, P. W. Boonstra, P. d. Heyer, and T. Ebels EXCLUSIVE USE OF ARTERIAL GRAFTS IN CORONARY ARTERY BYPASS OPERATIONS FOR THREE-VESSEL DISEASE: USE OF BOTH THORACIC ARTERIES AND THE GASTROEPIPLOIC ARTERY IN 256 CONSECUTIVE PATIENTS J. Thorac. Cardiovasc. Surg., October 1, 1996; 112(4): 935 - 942. [Abstract] [Full Text]

				L. R. Gerola, L. B. Puig, L. F. P. Moreira, G. V. Cividanes, G. P. Gemha, R. C. M. Souto, E. C. Oppi, and A. H. S. Souza Right Internal Thoracic Artery Through the Transverse Sinus in Myocardial Revascularization Ann. Thorac. Surg., June 1, 1996; 61(6): 1708 - 1712. [Abstract] [Full Text]

				J. Pym, P. Brown, M. Pearson, and J. Parker Right Gastroepiploic-to-Coronary Artery Bypass : The First Decade of Use Circulation, November 1, 1995; 92(9): 45 - 49. [Abstract] [Full Text]

				E. Dregelid, K. Heldal, F. Resch, L. Stangeland, K. Breivik, and E. Svendsen Dilation of the internal mammary artery by external and intraluminal papaverine application J. Thorac. Cardiovasc. Surg., September 1, 1995; 110(3): 697 - 703. [Abstract] [Full Text]

				O. Jegaden, A. Eker, P. Montagna, J. Ossette, G. De Gevigney, G. Finet, A. S. Pierre, D. Revel, R. Itti, and P. H. Mikaeloff Risk and Results of Bypass Grafting Using Bilateral Internal Mammary and Right Gastroepiploic Arteries Ann. Thorac. Surg., April 1, 1995; 59(4): 955 - 960. [Abstract] [Full Text]

				C. C. Canver, V. M. Armstrong, R. D. Nichols, and R. M. Mentzer Jr Color-Flow Duplex Ultrasound Assessment of Internal Thoracic Artery Graft After Coronary Bypass Ann. Thorac. Surg., February 1, 1995; 59(2): 389 - 392. [Abstract] [Full Text]

				M. Nasu, T. Akasaka, T. Okazaki, M. Shinkai, H. Fujiwara, J. Sono, Y. Okada, S. Miyamoto, S. Nishiuchi, J. Yoshikawa, et al. Postoperative Flow Characteristics of Left Internal Thoracic Artery Grafts Ann. Thorac. Surg., January 1, 1995; 59(1): 154 - 162. [Abstract] [Full Text]