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 to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours





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.
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.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


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

Sign In to Access Full Content

Related Content

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