Coronary Artery Bypass Grafting (CABG) is a type of heart surgery which improves blood flow to the heart. CABG surgery is mostly suitable for people suffering from severe Coronary Heart Disease (CHD). LIMA RIMA Y GRAFT is the MOST effective methods of Total Arterial Grafting. The bilateral Internal Mammary Arteries i.e. Left Internal Mammary Artery (LIMA) and Right Internal Mammary Artery (RIMA) conduits are usually used for Total Arterial Grafting in CABG. LIMA RIMA Y CABG procedure is done on beating heart (off-pump).

Previously the veins from the legs were used as a conduit for bypass surgery but the longevity of leg vein is not more than 7 to 10 years. They slowly degenerate because veins from the legs are unable to tolerate high pressure present inside a human coronary circulation. Hence Internal Mammary Arteries i.e. LIMA and RIMA are used as a conduit for bypass surgery. Today, doctors are performing total arterial grafting by using both the Left (LIMA) and the Right (RIMA) internal mammary arteries.

LIMA and RIMA are located close to the heart hence they are actually favored by many doctors. The LIMA stem is used to graft the LAD and Diagonal branches while RIMA stem is used to graft the OMs, PLV and PDA branches.

These arteries have two major advantages in addition to their location including:

• Mammary arteries are already attached to the main artery known as the aorta. Hence there is need to disconnect only its other end and to graft onto the diseased coronary artery.
• LIMA and RIMA arteries are more familiar to a forceful blood flow than a saphenous vein. So that the LIMA or RIMA arteries are more durable for longer time.

Indications of LIMA RIMA Y OFF CABG

Indications of LIMA RIMA Y OFF CABG (Coronary Artery Bypass Grafting) include:

• Left main coronary artery stenosis
• Stenosis of proximal LAD and proximal circumflex
• 3-vessel disease in asymptomatic patients
• 3-vessel disease with proximal LAD stenosis in patients with poor left ventricular function
• 1-or 2-vessel disease and larger area of Viable Myocardium in high risk area in patients with stable angina

Most of the patients with LIMA RIMA Y OFF PUMP CABG can live a trouble free life up to 25-30 years.