title: Short-term complications after bilateral internal mammary artery grafting--a retrospective study.
abstract: OBJECTIVE
  To analyze our experience of conducting Bilateral Internal Mammary Artery (BIMA) grafting, using both pedicled and free grafts for coronary revascularization, assessing the safety and efficacy of the procedure and comparing any differences observed between the two techniques of harvesting the grafts.
  
  
  METHODS
  A retrospective cross sectional study was conducted in July 2010 in which all 48 patients undergoing bilateral internal mammary artery grafting for coronary bypass surgery at the Aga Khan University Hospital from 1996 to 2010 were reviewed and evaluated. The main outcome measures were perioperative mortality and early morbidity with particular reference to cerebrovascular accidents, sternal wound complications and re-opening for bleeding. Chi-square test was used to elicit any meaningful associations between patient characteristics and post-operative outcomes.
  
  
  RESULTS
  Of the 48 patients undergoing bilateral IMA grafting, 46 were males and 2 females. The mean age was 48 +/- 9.4 years. Dyslipidaemia and smoking were the most common identifiable risk factors for coronary vascular disease. Following the 40 elective and 8 emergent surgeries, there was one hospital death. The most common post-operative complications were arrhythmias and wound infection. Diabetes and obesity were not observed to be associated with an increased risk of developing surgical site infection.
  
  
  CONCLUSIONS
  Our study suggests that the short-term efficacy and the safety profile of bilateral IMA grafting for coronary revascularization is clinically acceptable. Long-term follow-up studies should be done to assess the cardiac event-free survival of these individuals evaluating its applicability as a routine for coronary artery bypass grafting in Pakistan.
authors.affiliation: Medical College, Department of Surgery, Aga Khan University, Karachi.
authors.forename: Hashim Muhammad
authors.initials: HM
authors.lastname: Hanif
authors.forename: Zeb Ijaz
authors.initials: ZI
authors.lastname: Saeed
authors.forename: Adil
authors.initials: A
authors.lastname: Sheikh
authors.forename: Syed
authors.initials: S
authors.lastname: Shahabuddin
authors.forename: Hasanat
authors.initials: H
authors.lastname: Sharif
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome