Abstract: To review the feasibility of sequential left internal mammary artery （LIMA）grafting in an offpump coronary artery bypass graft(OPCABG), and to present an objective evidence for clinical application. MethodsBetween March 2006 and February 2008, 72 consecutive patients who had undergone OPCABG with LIMA bypass grafts were included in this study. 36 patients with sequential LIMA grafting were enrolled into group A and the other nonsequential patients into group B. LIMA′s blood flow was measured when the hemodynamics stabilized after the grafts were finished with the Medistim Butterfly Flowmeter. SPSS10.0 statistic software was used for analysis. ResultsMean flow and Pulse index (PI) of the LIMA were significantly different between group A and B:（31±5.6）mL/min versus (21±2.8)mL/min and 2.0±0.3 versus 2.7±0.4 respectively(P＜0.01). ConclusionThe LIMA can provide an adequate blood flow for the myocardium supplied by diagonal, intermediat remus, left interventricular branch and even more areas. It can also ensure arterialization of a coronary bypass graft for a longterm patency rate.

Key words: Coronary disease, Offpump, Internal mammary artery, Sequential anastomosis, Blood flowmeter