Reappraisal of importance of the left internal mammary artery to the left anterior descending artery in improving mid-term outcome in patients with severe left ventricular dysfunction.

We sought to investigate the effects of the left internal mammary artery anastomosed to the left anterior descending artery for improving mid-term outcome in patients with severe left ventricular dysfunction. Twenty consecutive coronary artery bypass grafts performed by a single surgeon for less than 35% ejection fraction patients were reviewed retrospectively from April 2000 to November 2008. There was one perioperative death (5.0% mortality). The mean survival was 55 months with an actual 5-year survival rate of 75%. Echocardiography showed the ejection fraction improved to 10.7 +/- 0.32% (p < 0.01). The strongest correlation was observed between both the flow and the pulsatile index of the left internal mammary artery measured intraoperatively by transit time flow meter and the postoperative ejection fraction improvement (R2=0.737 and 0.639, respectively). We reappraised the mid-term beneficial effects of the internal mammary artery anastomosed to the left anterior descending artery in patients with severe left ventricular function.