Early Results with Bilateral and Single Internal Mammary Artery Grafts. Are They Different?

Between June 1991 and June 1996, 391 patients underwent isolated myocardial revascularization using bilateral internal mammary artery. Three hundred and sixty-five of these patients could be matched retrospectively on the basis of preoperative characteristics with 365 patients operated on during same period who had left internal mammary artery as a single or sequential graft with additional vein grafts. The cardiopulmonary bypass times and aortic cross-clamp times were similar in both groups. There were no statistically significant differences in the two groups in terms of operative mortality (0.55% versus 0.82%), perioperative myocardial infarction (2.46% versus 2.19%), low cardiac output (1.64% versus 1.09%), reexplorations (1.10% versus 1.92%), wound complications (1.10% versus 2.46%), length of stay in the intensive care unit, and total hospital stay. The incidence of respiratory, central nervous system, and renal complications showed no difference between the two groups. Logistic regression analysis showed that the number of internal mammary artery grafts was not a predictor for perioperative complications. If better long-term event-free survival is associated with the use of bilateral internal mammary artery, it should be used wherever possible.