In situ saphenous vein graft bypass surgery is a standard procedure for infrainguinal arterial reconstruction. Since revascularization is commonly applied in below the knee region, the application of in situ saphenous vein graft bypass is becoming increasingly. We, however, recently experienced the complication of phlebitis due to unligated branches of the saphenous vein in this procedure. We here report the case and the efficacy of intraoperative angiography and postoperative ultrasound scanning to avoid such a complication.

We experienced 26 cases of free internal mammary artery (IMA) grafting for coronary artery bypass (CABG) during past 44 months. There were 3, 6 distal anastomoses per patient and 1.6 distal anastomoses per patient were performed with free IMA. The early mortality rate (within 1 month after surgery) was 3.8%. The surgical complications were 0 in mediastintis requiring operation, 0 in reoperation for bleeding and 1; phrenic nerve paralysis with respiratory dysfunction, the patency rate at 1 month after surgery were 97.2% in free IMA and were 96.1% in in-situ IMA. Conclusion was as followed that the use of free IMA for CABG provided excellent result in early period and we would anticipate to expand the use of IMA.