[Effects and causes of additional vein graft following IMA grafting in CABG].

The use of the internal mammary artery (IMA) in coronary artery bypass grafting (CABG) is recently common. The authors have been actively using the IMA in graft of the anterior descending artery (LAD). However, there are cases in which the onset of ventricular fibrillation or low cardiac output occurred around weaning from CPB or chest closure. We have experienced 8 such cases, 3 of which expired due to LOS or renal failure. When the IMA is to be used in CABG, one must be extremely cautious in next cases. 1. Cases of 3 VD with good EF. 2. Cases of OMI in RCA area or not to be expected complete revascularization in inferior wall. 3. Cases in the absence of collateral between R and L coronaries. In such cases, IABP should be carried out and anastomosed with an additional saphenous vein graft (SVG) at that coronary artery.