Mammary artery

Mammary artery refers to the internal mammary artery (IMA), also known as the internal thoracic artery. It is a crucial artery that originates from the subclavian artery and runs down the inside of the chest wall. The mammary artery is of significant interest in both anatomy and cardiology, particularly because of its use in coronary artery bypass surgery (CABG).

Anatomy

The internal mammary artery is a paired artery, with one running on each side of the sternum. After originating from the first part of the subclavian artery, it descends into the chest, supplying blood to the chest wall and the breasts. The IMA gives off several branches, including the anterior intercostal arteries, which supply the upper intercostal spaces, and the musculophrenic and the superior epigastric arteries.

Clinical Significance

The mammary artery is of paramount importance in the field of cardiac surgery. Its role in coronary artery bypass grafting (CABG) has been well established since the 1960s. The artery is used as a graft to bypass obstructed coronary arteries, a procedure that improves blood flow to the heart muscle. The use of the IMA in CABG is preferred due to its superior long-term patency rates compared to saphenous vein grafts.

Mammary Artery Harvesting

During CABG, the mammary artery can be harvested in two ways: as a pedicled graft or as a free graft. In the pedicled approach, the artery is left attached to its surrounding tissue to preserve its collateral blood supply. In contrast, the free graft technique involves completely detaching the artery and then reattaching it to the coronary artery.

Complications

Complications associated with the use of the mammary artery in CABG include bleeding, infection, and issues related to inadequate blood flow through the graft. However, these complications are relatively rare, and the benefits of using the mammary artery for coronary artery bypass grafting generally outweigh the risks.

Research and Future Directions

Research continues into the optimal use of the mammary artery in cardiac surgery, including studies on the long-term outcomes of patients who have undergone CABG using the mammary artery. There is also interest in developing minimally invasive techniques for harvesting the mammary artery to reduce recovery time and complications.

See Also

• Coronary artery bypass surgery
• Cardiac surgery
• Subclavian artery
• Coronary artery disease