Results of Bilateral Internal Mammary Artery Use in OPCAB: Report of 200 Cases

Skeletonized harvesting of the bilateral internal mammary arteries (BIMA) decreases the occurrence of sternal devascularization, thus decreasing the risk of sternal complications, while better patency rates improve survival in all patients.
From March 1997 to June 2003, 200 patients underwent bilateral skeletonized IMA grafting during off pump coronary artery bypass grafting (OPCAB). Of the 178 men and 22 women, 48 were older than 60 years, and 68 had diabetes (22 insulin, and 46 non- insulin dependent).
Hospital mortality in the BIMA series was 1 patient (0.5 %). This patient had COPD. Early postoperative morbidity included bleeding in 2 patients (1%), mediastinitis in 2 patients (1%), low cardiac output in 2 patients (0.5%) requiring intra-aortic balloon-pump and perioperative myocardial infarction in one patient (0.5%).
Bilateral skeletonized IMA grafting is associated with satisfactory results not only in elderly patients but also in diabetic patients; however, it is not recommended in patients with chronic obstructive pulmonary disease