title: Sequential internal mammary artery grafts: clinical and angiographic assessment.
abstract: Between January 1988 and August 1992, the internal mammary artery was used as a sequential graft to the left anterior descending artery and/or diagonal branch in 34 patients. One patient died in hospital. After surgery all survivors were free from angina for a follow-up of up to 4 years. Recatheterization was performed in 33 patients within 1 year of surgery. Postoperative angiography showed that 65 anastomoses (98%) were patent, but three patent grafts (5%) between the proximal and distal sequential anastomoses showed 'string sign'. It is important to prevent 'string sign' in sequential grafting. It is considered that sequential internal mammary artery grafting should be limited to coronary arteries with severe stenosis that divides anastomosed coronary arteries into two.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, St Mary's Hospital, Kurume, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tashiro
authors.forename: K
authors.initials: K
authors.lastname: Todo
authors.forename: Y
authors.initials: Y
authors.lastname: Haruta
authors.forename: H
authors.initials: H
authors.lastname: Yasunaga
authors.forename: Y
authors.initials: Y
authors.lastname: Tachikawa
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000401:mortality; D015996:Survival Rate