We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Double Internal Mammary-Coronary Artery Bypass

Hendrick B. Barner, MD
Arch Surg. 1974;109(5):627-630. doi:10.1001/archsurg.1974.01360050025007.
Text Size: A A A
Published online


Double internal mammary-coronary artery bypass in 100 patients with angina was associated with 35 single-vein grafts and four double-vein grafts. Hospital mortality was 8%. Postoperative catheterization revealed patency of 80 of 84 (95%) right internal mammary artery (RIMA) grafts, 82 of 84 (97%) left internal mammary artery (LIMA) grafts, and 36 of 41(88%) vein grafts. At one year, 22 of 23 (96%) RIMA grafts and 22 of 22 LIMA grafts remained patent. There were two late deaths, one late infarction, and three of 23 patients with angina at one year. Five of 45 IMA grafts had diffuse narrowing. The right and left IMA are hemodynamically similar, but the right will usually not reach beyond the acute margin and is smaller than the right coronary artery (RCA) one third of the time. The LIMA graft is the graft of choice for left anterior descending (LAD) reconstruction, but use of the RIMA for RCA or LAD bypass must be based on the age of the patient, the size of the coronary artery, and the distribution of atherosclerosis.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.