RETROGRADE INTERNAL MAMMARY ARTERY AS CORONARY-BYPASS - A PROSPECTIVE-STUDY WITH POSTOPERATIVE ANGIOGRAPHIC EVALUATION

Although the internal mammary artery (IMA) as a coronary graft offers better long-term patency than the saphenous vein, a factor limiting it s use has been the length of the artery's pedicle. In an attempt to ov ercome this limitation, we evaluated the use of retrograde right IMA i n a prospective study. In ten patients scheduled for routine coronary artery bypass surgery, bilateral IMA grafting was used, the left IMA i n routine fashion, but the right IMA dissected from the level of the f irst rib, cut there and placed as an inverted graft. Three months post operatively the patients were clinically evaluated with stress exercis e test (n = 10) and coronary angiography (n = 9). No patient had recur rence of angina. Angiography revealed patency of the retrograde right IMA graft in six of nine patients. On the basis of these data we do no t recommend routine use of retrograde IMA.