What is a secondary use of the internal mammary artery in cardiac procedures?

The internal mammary artery (IMA), also known as the internal thoracic artery, is frequently used in coronary artery bypass grafting (CABG) procedures due to its favorable characteristics, such as its robust blood flow and resistance to atherosclerosis. Its primary use is as a graft to bypass the left anterior descending (LAD) coronary artery, which is crucial because the LAD supplies a significant portion of the heart muscle and its occlusion can lead to severe cardiac issues.

In this context, while the IMA can be used for bypassing various coronary arteries, its most recognized and effective application is as a conduit for the left anterior descending artery. The reason for this preference is due to the excellent long-term patency rates associated with using the internal mammary artery for this specific vessel. Research has shown that using the IMA to graft the LAD significantly improves patient outcomes when compared to using saphenous vein grafts for the same purpose.

In situations where other options are considered, the internal mammary artery can technically be used to bypass the right coronary artery or the circumflex artery; however, the most established and beneficial use remains its connection to the left anterior descending artery. Understanding this reflects the importance of graft selection based on anatomical and physiological