CHEST-WALL INFARCTION FOLLOWING BILATERAL INTERNAL MAMMARY TO CORONARY ARTERIAL BYPASS IN A PATIENT WITH A THORACOABDOMINAL ANEURYSM

A 69-year-old man with severe peripheral vascular disease and a known thoracoabdominal aortic aneurysm underwent bilateral internal mammary artery (BIMA) to coronary artery bypass grafting and aortic hemiarch r eplacement, He immediately thereafter developed massive chest wall isc hemia and infarction with a severe metabolic acidosis, and subsequentl y died, Chest wall infarction following BIMA harvesting has not been p reviously described. Cautious use of internal mammary arterial graftin g may be in order in the severe vasculopath with significant thrombo-o cclusive thoracoabdominal aortic disease.