CAN BOTH INTERNAL MAMMARY ARTERIES BE USE D SYSTEMATICALLY IN CORONARY-BYPASS SURGERY - A SERIES OF 560 PATIENTS

The grafts commonly used in coronary bypass surgery are the left inter nal mammary artery and the saphenous veins of the legs : the use of bo th internal mammary arteries, with potential long-term benefits, is on ly justified if the operative risk is not increased. Since 1987, the a uthors use both internal mammary arteries systematically in patients u nder 70 years of age and in good general condition. The retrospective analysis of 560 patients having undergone this surgery from 1987 to 19 94 was undertaken to determine if this surgical option is justified wi thout increased operative risk. The dissection of the mammary arteries is performed in a special manner by skeletonization technique. The to tal hospital complication rate was 12 % with 9 deaths in the first 30 postoperative days (1.6 %). Mediastinits was observed in 6 patients (1 .1 %) Early angiographic controls showed a patent mammary graft rate o f 98 %. The use of both internal mammary arteries does not therefore i ncrease postoperative morbidity or mortality. It may be proposed syste matically in patients in good general condition and may provide long-t erm benefits in graft patency rates.