Clinical results of free (aorta-coronary) internal thoracic artery grafting

In the two year period from 1989 to 1990, 22 patients (18 men, 4 women; age range from 40 to 59 years) underwent coronary artery bypass grafting (CABG) using in situ and free internal thoracic arteries (ITAs). 23 of total 38 ITA grafts were free grafts in the aorta-coronary position, mainly to provide sufficient graft length. All of 34 ITA grafts were patent in 20 patients with coronary arteriography about one month after operation. There were no early and late death, and all patients were free from angina after a 9.4 month mean follow-up. Perioperative complications included reoperation for the bleeding in one case and the elevation of left diaphragm in one case, but there was no other major complication such as perioperative myocardial infarction, cerebral infarction or mediastinitis. These results indicated that the free ITA could be applied as well as the in situ ITA in multiple CABG of the Japanese with good patency rate and low operative risk.