MYOCARDIAL REVASCULARIZATION WITH ONE OR 2 INTERNAL MAMMARY ARTERIES - COMPARISON OF LONG-TERM RESULTS

Background: Coronary bypass grafts made with internal mammary artery h ave better long term results than those made with saphenous vein. It i s possible that the use of both mammary arteries would lead to even be tter results. Aim: To compare the long term survival and the incidence of new coronary events of patients, in whom one or two mammary arteri es were used as coronary bypass grafts. Patients and methods: One hund red and eight randomly selected patients who received one mammary arte ry for myocardial revascularization and 108 patients, matched for prog nostic factors, who received two mammary arteries were studied. These patients were followed for a mean of 4 years (range 1 to 12 years). Op erative complications, hospital mortality and long term probability of being free of disease were compared in both groups. Results: Operativ e mortality was similar in both groups (0,9%). Patients that received two mammary arteries had a higher frequency of operative wound complic ations. Long term survival was 84% in patients who received one and 83 % in patients who received two mammary arteries. The probabilities of being free of myocardial infarction (92 and 82% respectively) and angi na (94 and 86% respectively) were lower in the later group. Conclusion s: Patients who received two mammary arteries had a higher probability of a long term disease free survival than patients who received one m ammary artery.