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The saphenous vein has been the traditional conduit for elective myocardial revascularization. Although readily available and adaptable to many configurations around the heart, it is prone to intimal hyperplasia and vein graft atherosclerosis, which diminish long-term patency and relief of symptoms. The internal mammary artery graft represents a marked improvement over the saphenous vein graft in many respects. Data are presented comparing saphenous vein graft patency with that of the internal mammary artery, bilateral internal mammary artery, free internal mammary artery, and sequential internal mammary artery grafts.
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