Comparative study of aorto-coronary bypass surgery using internal mammary artery grafts and saphenous vein grafts

From April, 1985, through March, 1988, 202 patients had aorto-coronary artery bypass (CABG). In two series of consecutive patients who underwent CABG alone with the saphenous vein (SVG) or the internal mammary artery (IMA), mortality, morbidity and postoperative angiographic findings were compared with two series. The mean number of grafts placed was 1.8 per patient (1 to 4 grafts) in IMA group and 2.2 per patient (1 to 4 grafts) in SVG group. Mortality was 3% in two groups. The intraoperatively mean blood flow of graft to LAD in SVG and the mean blood flow of free end of IMA had no significant difference. The early patency rate (1.5 months) was 96% for 177 grafts in IMA group, 97% for 100 with IMA-LAD anastomosis, and 95% for 221 grafts in SVG group, 97.7% for 88 with SVG-LAD anastomosis. Morbidity was not significantly different. Many reports suggested that the long-term patency rate was good within the IMAG. In conclusion, the usefulness of IMAG in Japanese patients should be more stressed in young patients.