Myocardial revascularization surgery with bilateral internal mammary artery

Abstract

Introduction: The internal mammary artery is the only graft with a long-term impact on mortality in patients with coronary artery disease. Some questions limit the use of both arteries simultaneously, such as prolonged surgical time, risk of sternal infections, especially in diabetic and obese patients. This study sought to describe the 5-year experience in patients revascularized with bilateral internal mammary artery (BIMA). Methods: Descriptive cohort follow-up study. 42 patients underwent myocardial revascularization with BIMA between 2015-2020, Manuel-Uribe-Ángel Hospital, Envigado-Colombia. Secondary and primary information sources. Univariate analysis was developed for the description of variables. Results: Mean age of 55.2 years, 19% were diabetic, mean body mass index (BMI) 24.5 kg/sq.mt; severe coronary artery disease 90.5%, 95.2% with complete revascularization. No patient presented surgical site infection. Median follow-up of 5.1 years during which 5.4% suffered an acute myocardial infarction, 13.5% required percutaneous coronary intervention, 16.2% died, 33.3% of which were attributed to a cardiac cause. Discussion: The participants had a normal average BMI, 19% were diabetic; they had adequate metabolic control, presenting mean glycosylated hemoglobin of 7.09%. In the studied population there were no cases of surgical site infection and 16.2% of the cohort presented angina, which is lower than that described in other studies. Incidence of acute myocardial infarction and percutaneous coronary intervention was similar to the ones reported in other studies. Conclusion: In the studied population, patients with BMI in the normal range and glycemia with adequate metabolic control, myocardial revascularization with BIMA was a safe technique with acceptable medium-term cardiovascular outcomes.