Coronary artery bypass grafting by utilizing the internal mammary artery graft in 100 Japanese patients

The internal mammary artery (IMA) grafting for myocardial revascularization was performed in 100 Japanese patients during a three-year period. There were 86 males and 14 females with the mean age of 58 +/- 9 (37 approximately 75 year-old). Unilateral IMA was used in 88 patients and bilateral IMA was used in 12 patients. Sequential IMA grafting was performed in 5 patients. The sites of IMA grafting were 91 left anterior descending arteries (LAD), 16 diagonal branches, 8 circumflex arteries and 2 right coronary arteries. Saphenous vein or gastroepiploic artery was concomitantly used to bypass the other coronary arteries in 90 patients. The number of distal anastomosis ranged from 1 to 6 and the mean was 2.8 per patient. Two patients died within 30 days and one patient died at 3 months after surgery. Perioperative myocardial infarction was noted in 3 patients. Symptomatic relief was obtained in 94 (97%) of 97 survivors. The patency of the IMA graft at mean 2.2 postoperative months was 97% (58/60) in LAD, 100% (14/14) in the diagonal branch, 100% (5/5) in the circumflex artery, 100% (1/1) in the right coronary artery, and 98% (78/80) in over-all grafted coronary arteries. Pre- and postoperative exercise thallium scintigraphy in 13 patients, who received the IMA graft to severely stenosed LAD, showed significant improvement of the washout ratio (from 33.1 +/- 16.9% to 47.4 +/- 14.8%) which was nearly equivalent to that of the saphenous vein graft to LAD (from 24.8 +/- 6.2% to 48.1 +/- 6.6%, n = 7).(ABSTRACT TRUNCATED AT 250 WORDS)