Internal mammary artery versus autogenous vein for coronary artery bypass graft.

Aortocoronary venous graft (ACVG) and internal mammary artery graft (IMAG) are currently the two most popular choices for coronary artery bypass. The morphologic alteration and susceptibility to atheromatous degeneration of the IMAG were compared with the ACVG. Six of 12 surviving dogs with IMAGs were fed a hyperlipidemic diet and six were placed on a regular diet. All dogs were sacrificed 3-15 months after surgery. Twelve of 28 long-term surviving dogs with ACVGs were also on hyperlipidemic diets, and all were sacrificed 3-18 months after surgery. Arteriography and electron microscopy were performed in selected cases, and histology was performed in all cases. All long-term IMAGs remained patent; 83 percent (5/6) "-regular" diet arteries were normal, with no intimal proliferation, while 33 percent (2/6) "hyperlipidemic" IMAGs had diffuse atheroma. Eighty-two percent of ACVGs revealed significant atherosclerosis. Severity of arteriosclerotic involvement of the ACVG was far greater than that of the native