[A case of intimal dissection of the left internal mammary artery grafting].

A 73-year-old man underwent reoperation using the in situ left internal mammary artery (IMA) because of the stenosis of the vein graft to the left anterior descending artery (LAD). The patient recovered free from angina but angiography performed 1 month after operation revealed the dissection of intima of the left IMA. Use of the IMA in coronary artery bypass grafting (CABG) is now generally accepted as the optimal method of myocardial revascuralization and the use of the left IMA to the LAD has become a routine procedure in our CABG surgery. However, because the IMA wall is friable and disruption occurs easily, especially in the elder, much care should be taken during mobilization of the IMA.