title: Coronary artery bypass grafting using both internal mammary arteries in patients with diabetes mellitus.
abstract: OBJECTIVE
  We sought to describe the use of both internal mammary arteries (IMA) in patients with diabetes mellitus (DM) submitted to coronary artery bypass grafting (CABG).
  
  
  METHODS
  Between January of 1995 to August of 2005, 4.569 patients received isolated CABG in our institution, of these, 1.298 had DM. Mean sample age was 62 years, and total mortality was 2.18% (100 patients). We have used both IMA's in 700 patients, that here are split in two groups, with DM (group I, 148 patients), and without DM (group II, 552 patients). Patient selection for double IMA grafting was based on coronary artery anatomy and sternal bone quality, the later was evaluated during sternal transsection. When these two factors were considered favorable, we harvested both IMA's, not mattering if the patient had or had not DM. During IMA's harvest, care was taken not to open the pleural spaces.
  
  
  RESULTS
  There was small difference between the two groups in terms of morbidity and mortality.
  
  
  CONCLUSIONS
  Our data suggest that patients with DM can benefit of double IMA's grafting, with little increase in risk for complications if its application is carefully indicated.
authors.affiliation: Hospital do Coração - HCor, São Paulo, SP. smartins@hcor.com.br
authors.forename: Stevan Krieger
authors.initials: SK
authors.lastname: Martins
authors.forename: Magaly Arrais dos
authors.initials: MA
authors.lastname: Santos
authors.forename: Freddy H Ponce
authors.initials: FH
authors.lastname: Tirado
authors.forename: Francisco C E
authors.initials: FC
authors.lastname: Martins
authors.forename: Hassan F
authors.initials: HF
authors.lastname: Malat
authors.forename: Adib Domingos
authors.initials: AD
authors.lastname: Jatene
authors.forename: Luiz Carlos Bento de
authors.initials: LC
authors.lastname: Souza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D003327:Coronary Disease / Q000601:surgery*; D003925:Diabetic Angiopathies / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008875:Middle Aged; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery