Abstract
Twenty patients who underwent internal mammary artery implantation for the treatment of incapacitating angina pectoris were studied before and 1 year after operation. Studies included treadmill exercise test, right heart catheterization at rest and during exercise, selective coronary adenography and selective visualization of the implanted arteries. Operative mortality was 8.5 percent. Postoperatively, only 1 patient showed improvement in the treadmill exercise stress test. Thirteen of 18 patients demonstrated a deterioration in hemodynamic performance. Angiographic studies revealed only 3 patients having collateral vessels large enough to fill a major coronary artery. These data confirm the lack of objective evidence of benefit following internal mammary artery implantation; the frequent deterioration of myocardial performance seen may be related to the operative procedure.
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