Early results with bilateral internal mammary artery grafting in coronary reoperations

In recent years, use of the internal mammary artery (IMA) as first graft of choice has been expanded with bilateral and sequential grafts in primary myocardial revascularization. The use of bilateral IMA grafts in reoperation has seldom been reported. The experience and early results with bilateral IMA grafting in 47 patients undergoing coronary reoperation are described. Hospital mortality was 6.3%. Four patients had postoperative signs of low cardiac output, and 4 had a perioperative myocardial infarction. At follow-up (18 ± 18 months), 2 cardiac-related, late deaths were noted. Thirteen patients (29%) improved 1 New York Heart Association class, and 28 (63%) improved >1 class. In 1 of 44 surviving patients, operation did not result in a decrease in angina. On the basis of the early results, the bilateral use of the IMA in coronary reoperation appears justified.