title: [Application of bilateral internal mammary artery in coronary artery bypass grafting].
abstract: OBJECTIVE
  To evaluate the effects of application of bilateral internal mammary artery grafts in coronary artery by pass grafting (CABG).
  
  
  METHODS
  From Jan. 1998 to Mar. 2001, 51 patients with coronary arteriosclerotic cardiopathy, all males, aged 36 - 65 (average 49.9 years), underwent coronary artery bypass grafting with bilateral internal mammary artery grafts. The pathologic change involved three branches of coronary artery in 48 cases and involved the left main trunk in 3 cases. 37 patients had the history of myocardial infarction. Four cases were complicated by left ventricular aneurysm. 47 cases were operated upon on-pump and 4 off-pump. Left ventricular aneurysmectomy was done in 4 patients and coronary endarterectomy in 1 patient. The patterns of anastomosis were as follows: right internal mammary artery (RIMA) to left anterior descending artery (LAD) and left internal mammary artery (LIMA) to obtuse marginal (OM) in 39 cases, LIMA to LAD and RIMA to right coronary artery (RCA) in 9 cases, and LIMA to LAD and RIMA to OM in 3 cases. Gastroepiploic artery and left radical artery were used in other bypass grafting. The average number of grafts used for each case was 3.
  
  
  RESULTS
  There were 3 early operative deaths, with an early operative mortality rate of 5.9%. One patient died of low output syndrome due to perioperative myocardial infection, 1 patient died of refractory arrhythmia, and 1 patient died of cerebral accident 40 days after operation. Intraaortic balloon pump was used in 4 cases post-operatively. Mediastinal infection occurred in 2 patients. The patients were followed up for 2 to 39 months (average 15.5 months). During the follow-up, no angina pectoris occurred and ultrasonography showed that the bilateral internal mammary artery grafts were unobstructed in all patients.
  
  
  CONCLUSIONS
  Bilateral internal mammary artery grafts can be applied effectively in CABG with a good short-term effect, especially for young patients.
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Lai
authors.forename: Fangjiong
authors.initials: F
authors.lastname: Huang
authors.forename: Jinfei
authors.initials: J
authors.lastname: Yang
authors.forename: Chunlei
authors.initials: C
authors.lastname: Xu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome