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Internal mammary artery versus saphenous vein graft to the left anterior descending coronary artery: prospective randomized study with 10-year follow-up. 1988

R H Zeff, and C Kongtahworn, and L A Iannone, and D F Gordon, and T M Brown, and S J Phillips, and J R Skinner, and M Spector
Department of Cardiovascular Medicine and Surgery, Mercy Hospital Medical Center, Des Moines, IA.

In 1975, 80 patients undergoing revascularization were prospectively randomized to receive either a greater saphenous vein (SV) graft (41 patients, Group 1) or a left internal mammary artery (LIMA) graft (39 patients, Group 2) to the left anterior descending coronary artery (LAD). All patients were completely revascularized. The average number of grafts per patient in both groups was 3.2. Patients were followed 10 years; follow-up was 97.5% complete. Group 1 and Group 2 were compared in regard to mortality, treadmill response, myocardial infarction, reoperation, percutaneous transluminal coronary angioplasty, and return to work. Mortality in Group 1 was 17.9% versus 7.7% in Group 2 (p less than 0.05). Treadmill studies were positive in 17 Group 1 patients and 7 Group 2 patients (p less than 0.05). Myocardial infarctions occurred in 8 patients in Group 1 versus 3 in Group 2. The number of reoperations was 2 in Group 1 versus 1 in Group 2. Percutaneous transluminal coronary angioplasty was performed in 3 patients in Group 1 and 2 in Group 2. Repeat studies revealed 76.3% patency of the SV graft to the LAD (Group 1) and 94.6% patency of the LIMA graft to the LAD (Group 2). Cardiac-related mortality in Group 1 was 12.8% at 10 years (5 patients) versus 7.7% in Group 2 (3 patients). Based on this study, the IMA is a superior conduit for bypass to the LAD.

UI MeSH Term Description Entries
D008297 Male Males
D008323 Mammary Arteries Arteries originating from the subclavian or axillary arteries and distributing to the anterior thoracic wall, mediastinal structures, diaphragm, pectoral muscles and mammary gland. Internal Mammary Artery,Internal Thoracic Artery,Arteries, Internal Mammary,Arteries, Internal Thoracic,Arteries, Mammary,Artery, Internal Mammary,Artery, Internal Thoracic,Artery, Mammary,Internal Mammary Arteries,Internal Thoracic Arteries,Mammary Arteries, Internal,Mammary Artery,Mammary Artery, Internal,Thoracic Arteries, Internal,Thoracic Artery, Internal
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011897 Random Allocation A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. Randomization,Allocation, Random
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006331 Heart Diseases Pathological conditions involving the HEART including its structural and functional abnormalities. Cardiac Disorders,Heart Disorders,Cardiac Diseases,Cardiac Disease,Cardiac Disorder,Heart Disease,Heart Disorder
D006334 Heart Function Tests Examinations used to diagnose and treat heart conditions. Cardiac Function Tests,Cardiac Function Test,Function Test, Cardiac,Function Test, Heart,Function Tests, Cardiac,Function Tests, Heart,Heart Function Test,Test, Cardiac Function,Test, Heart Function,Tests, Cardiac Function,Tests, Heart Function
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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