This week I focused my research on the benefits of bilateral internal mammary artery grafts for CABG surgery. Through my past and present research, every article reaches the consensus that the left internal mammary artery to the LAD coronary artery has the greatest patency of any graft in CABG surgery. Therefore, all of the research being done since the early 1990's has been to research the best secondary conduit for CABG surgery. I focused my research on an NCBI case study performed in 2014 that compared the efficacy of RIMA grafts versus radial artery (RA) grafts in CABG surgery. A description of the study as well as the results are as follows.
Before this experiment even began the researchers stated that using a RIMA graft in CABG surgery tended to increase sternal wound infection in patients, especially in diabetic patients who are not able to heal their chest wall as well. This is the main reason why surgeons have decreased the use of bilateral IMA grafts in CABG surgery. In this case study, the surgeons used RIMA conduits in 747 patients and radial artery conduits in 779 patients (a total of 1526 patients). The results of the study found that RIMA grafts did not increase the chance of sternal wound infection in patients after completion of CABG surgery. The results also found that RA grafts increased the chance of late mortality and repeat CABG surgery in all patients, particularly obese and diabetic patients. This late mortality and repeat revascularization is a result of a lower graft patency for RA grafts than RIMA grafts. This study is salient to any prior beliefs of the harmful effects of RIMA grafts because the researchers proved that RIMA grafts do not increase any patient's (including diabetic patient's) chance of having a chest wound infection after CABG surgery. By disproving the main question mark about RIMA grafts, this case study has taken a big step in proving that RIMA grafts are one of if not the best secondary conduit in CABG surgery.
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