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To analyze the causes and the treatment of the internal mammary artery damage in coronary artery bypass grafting.
From July 1997 to April 2017, 10360 cases of coronary artery bypass grafting were performed by authors. 286 cases underwent internal mammary damage during harvesting. The main causes include dissection (30.07%), injury by electric knife(10.84%) and injury by clip. Therefore, great saphenous vein takes the place of injured internal mammary artery in 145 cases (50.88%), 65 cases(22.81%) underwent the free grafting of the injured internal mammary and other methods were taken.
1 patient died in the perioperative period, perioperative period myocardial infarction occurred in 1 patient, 2 patients occurred ventricular fibrillation during surgery, cerebral infarction occurred in 2 patients, 2 patients were assisted by intra-aortic balloon pump, converting MIDCAB to a full sternotomy occurred in 1 patient.
Internal mammary artery damage was sometimes occurred in coronary artery bypass grafting. In terms of the location of the internal mammary damage, they can be dealt with in different approaches. By applying great saphenous vein, free grafting of the injured internal mammary and other 11 methods, our protocol can be used as a bailout to internal mammary artery damage in coronary artery bypass grafting.