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The Journal of Thoracic and Cardiovascular Surgery, Vol 96, 19-29, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Histologic comparison of experimental coronary artery bypass grafts. Similarity of in situ and free internal mammary artery grafts

RC Daly, PM McCarthy, TA Orszulak, HV Schaff and WD Edwards
Section of Thoracic and Cardiovascular Surgery, Mayo Clinic, Rochester, Minn. 55905.

This study compares patency and histologic structure of in situ internal mammary artery grafts, free internal mammary artery grafts, stripped, free internal mammary artery grafts, and stripped, free superficial femoral artery grafts (a muscular artery model) in a canine model of coronary artery bypass. Twenty-four adult mongrel dogs underwent bypass of the circumflex coronary artery with one of the above grafts. Three months postoperatively, graft patency was assessed by angiogram, and postmortem specimens were studied by intraluminal injection of a dilute barium solution proximal to the graft. Proximal, mid, and distal segments of each graft were examined microscopically. In situ internal mammary artery grafts and free internal mammary artery grafts were not significantly different in regard to patency, vascular wall cellular structure, or perfusion of the vasa vasorum. The stripped, free internal mammary artery group had a higher incidence of thrombosis, intimal thickening, and medial injury than the pedicled (in situ and free internal mammary artery) grafts. This difference may be due to early vascular wall ischemia as a result of poor early perfusion of the vasa vasorum. The stripped, free superficial femoral artery grafts were all patent, but all had adventitial injury.

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