THE USE OF SAPHENOUS-VEIN CORONARY-ARTERY BYPASS GRAFTS (CABG) AND INTERNAL MAMMARY ARTERY (IMA) FOR SURGICAL-TREATMENT OF CORONARY HEART-DISEASE - COMPLICATIONS AND PATENCY RATES

The therapy of choise for the surgical treatment of coronary heart dis ease is an aorto-coronary bypass-operation using autologous saphenous vein and the internal mammary (thoracic) artery. The most important fa ctor that influences long-term results of the bypass-operation is the patency rate of the autologous grafts used for coronary revascularizat ion. In this respect the internal mammary artery compares favourably w ith saphenous vein grafts. On the other hand, however, compared to the saphenous vein the harvesting of the internal mammary artery involves a greater surgical trauma which in turn leads to a higher incidence o f postoperative bleeding and wound-healing complications. Inspite of p otential higher initial hazards the internal mammary artery should be used routinely for coronary revascularization to achieve optimal long- term results.