Combined Internal Mammary Artery Graft in Coronary Bypass: 18-Year Follow-Up

Graft preference is a key point for long-term patency in coronary artery bypass grafting. We present a patient with multivessel coronary artery disease who underwent coronary artery bypass grafting 18 years ago. Revascularization of the left coronary system was performed by using a combined internal mammary artery (IMA) graft, which consisted of an end-to-end anastomosis of left IMA (in situ) and right IMA (free), with the interposition of a small piece of vein. A coronary angiography at the 18-year follow-up revealed patency of all sequential anastomoses with an enlarged combined IMA graft. (Ann Thorac Surg 2009; 87: e57-8) (C) 2009 by The Society of Thoracic Surgeons