Why is Lima used for CABG?


Why is the internal mammary artery used for grafts?

The internal mammary artery (IMA) grafts have been associated with long-term patency and improved survival as compared to saphenous vein grafts (SVGs). Early failure of IMA is attributed to poor surgical technique and less with thrombosis.


Coronary artery bypass grafting (CABG) is an evidence-based, effective treatment method for patients with coronary artery disease (CAD). The most advantageous outcome of CABG is the graft of the left internal mammary artery (LIMA) to the left anterior descending (LAD) artery.

What does the Lima supply?

When the bilateral internal mammary artery (BIMA) is grafted in situ, the left internal mammary artery (LIMA) is generally used for the left descending artery (LAD) and the RIMA for the right coronary artery (RCA), or for the lateral wall, usually going through the transverse sinus.

What artery is the widow maker?

The widow-maker is a massive heart attack that occurs when the left anterior descending artery (LAD) is totally or almost completely blocked. The critical blockage in the artery stops, usually a blood clot, stops all the blood flow to the left side of the heart, causing the heart to stop beating normally.

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Can you live 20 years after bypass surgery?

Survival at 20 years after surgery with and without hypertension was 27% and 41%, respectively. Similarly, 20-year survival was 37% and 29% for men and women. Conclusions— Symptomatic coronary atherosclerotic heart disease requiring surgical revascularization is progressive with continuing events and mortality.

Can the LAD artery be bypassed?

Bypass is most commonly performed by placing the distal left internal mammary artery to the LAD. The LAD is the most important blood vessel that is commonly bypassed during surgical revascularization for ischemic coronary artery disease.

How long does a Lima bypass last?

If a patient has a LIMA bypass, it is almost 90% likely to remain open, even 10 years after the operation, and that is just great. For the other blockages where an SVG graft is used, the bypasses are about 50% likely to remain open at 10 years.

What happens when LAD is blocked?

The LAD artery carries fresh blood into the heart so that the heart gets the oxygen it needs to pump properly. If it’s blocked, the heart can stop very fast — which is why this type of heart attack is called a “widowmaker.”

What is SVG to LAD?

Plot of time to development of 50% to 99% stenosis in internal mammary artery (IMA) and single saphenous vein graft (SVG) to the left anterior descending coronary artery (LAD).

What is Lima Rima?

In fact, given that they are located close to the heart and coronary arteries, the left and right internal mammary arteries (LIMA and RIMA) are actually favoured by many doctors. These arteries have two distinct advantages besides their location: Mammary arteries are already attached to the main artery (the aorta).

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What does Lima mean in cardiology?

Over the last two decades, many studies have shown better long-term patency rates and survival in patients undergoing coronary artery bypass grafting (CABG) with left internal mammary artery (LIMA) to the left anterior descending artery (LAD).

What is SVG RCA?

Selective saphenous vein graft to right coronary artery (SVG-RCA) angiogram demonstrating patent graft with side to end anastomosis to the RV marginal artery, and distal right posterolateral artery. End to end vein graft limb from mid SVG-RCA to the left posterior descending artery (LPDA).