Original study
Morbidity following coronary artery revascularisation with the internal mammary artery

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Abstract

To investigate the morbidity after coronary artery bypass grafting, one hundred and seventy-eight patients were retrospectively studied with a minimum follow-up period of one year. Although there was no difference in the incidence and distribution of pain in hospital, seventy percent of patients who had an internal mammary artery used as one of the bypass conduits experienced chest wound pain after discharge from hospital compared to 51.7% of patients who had vein grafts alone (P < 0.05). Twenty-three percent of patients who had their left internal mammary arteries harvested experienced chronic left-sided chest wall pain compared to 4.5% of patients who had vein grafts only (P < 0.005). The possible factors responsible are discussed and a review made of the complications which may result from using the internal mammary artery in coronary artery surgery.

References (35)

Cited by (34)

  • Peripheral Nerve Injury in Cardiac Surgery

    2018, Journal of Cardiothoracic and Vascular Anesthesia
    Citation Excerpt :

    Conacher et al67 made the same observation in 2 patients who developed atypical, nonanginal chest pain after IMA harvesting. Later, Eng et al68 evaluated 178 patients and found a strong correlation between left-sided chest wall dysesthesias and IMA harvest, implicating injury to the intercostal nerves as playing a primary role in the syndrome. Mailis et al then confirmed their earlier findings with a new study of 37 patients who underwent CABG with IMA harvest and reported 27 (73%) had definite anterior intercostal nerve damage and 4 (15%) had persistent spontaneous pain 5 to 28 months later.69

  • Endovascular treatment of coronary steal

    2011, Cardiovascular Revascularization Medicine
    Citation Excerpt :

    In some patients, diversion of blood from myocardium into intercostal or pericardial branches of the internal mammary artery may cause coronary steal. Visualization of large LIMA side branches in patients with recurrent post-CAB angina does not necessarily imply that a steal syndrome is occurring [10,11]. On the other hand, symptomatic relief and occasionally reversal of “stress test” ischemia have been achieved by side branch occlusions [1,5,7].

  • Postoperative pain after cardiac surgery

    2010, Journal of Cardiothoracic and Vascular Anesthesia
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