LEFT INTERNAL THORACIC ARTERY GRAFT OCCLUSION FOLLOWING MEDIASTINAL RADIATION-THERAPY

Premature coronary artery disease is a late consequence of mediastinal radiation therapy. Many of these patients have been successfully trea ted with coronary bypass surgery. A 51-year-old man underwent bypass s urgery for severe multivessel coronary disease 18 years following radi ation therapy for a posterior mediastinal tumor. Recurrent angina 1 ye ar later occurred following closure of the left internal thoracic arte ry graft. We suspect that this occurred as a consequence of injury sus tained during mediastinal irradiation. Patients who have undergone pri or mediastinal radiation therapy may not be assured the excellent long -term patency of the internal thoracic artery graft which has been rep orted for the general population. Saphenous vein grafts probably shoul d be considered instead.