Midterm angiographic study of five recycled mammary arteries during four coronary redos

Background. Recently the technical feasibility of reusing the left internal mammary artery (IMA) in coronary artery reoperation has been documented, but the patency of “recycled” IMAs has not yet been established. Methods. In 4 patients undergoing coronary reoperation, five internal mammary arteries (3 left IMAs and 2 right IMAs) that were patent but severely stenotic at the anastomotic site were taken down and reused. In 2 cases the IMAs were reanastomosed to the same target coronary artery, in 2 cases the IMAs were rerouted to another coronary artery, and in 1 case an interposition of a short segment of the greater saphenous vein was needed to reach the target coronary artery. Results. Angiographic midterm evaluation, performed between 7 and 35 months postoperatively, showed patency of all the reused grafts without stenoses. Conclusions. When feasible, recycling of the IMAs may be considered if one or both IMAs have been previously used and are stenotic in the perianastomotic area, or when there is a stenosis in the native coronary artery distal to the anastomosis itself.