Bypass of the right and circumflex coronary arteries with the internal mammary artery.

Our experience with the internal mammary artery (IMA) for coronary bypass grafting in the past 3 years includes 323 grafts in 253 patients. After an initial group of IMA to left anterior descending (LAD) coronary artery grafts, we began using the IMA to bypass circumflex and small right coronary arteries (RCA). This report describes our experience with IMA bypass of coronary vessels other than the LAD. A total of 96 patients have had an IMA graft to the circumflex or RCA. Most of these patients had two or more bypasses. The mortality rate for this group has been 7 per cent, 7 of 96 patients. Postoperative angiography in 82 of 89 survivors has shown a patency rate of 98 per cent in 83 of 85 grafts studied. We conclude that the IMA is the vessel of choice for coronary artery bypass and that it can be used to bypass any of the main coronary arteries.