Internal mammary artery conduit: an additional surgical procedure in difficult coarctation of the aorta.

Between October 1986 and February 1987 two young men with coarctation of the aorta and a hypoplastic isthmus were treated by a combined resection and isthmusplasty with implantation of the left internal mammary artery to the distal aorta. An appreciable drop in the systolic gradient was seen in both patients after the mammary artery anastomosis and haemodynamic variables across the repair continued to improve postoperatively. Digital transvenous subtraction angiography five months after operation showed a satisfactory mammary artery conduit across the repaired coarctation.