Prevalence and correlation of atherosclerosis in internal mammary artery and coronaries: an autopsy study

  • Suraj Jain Bangalore Medical College and Research Institute, Bangalore
  • Dayananda S Biligi Bangalore Medical College and Research Institute, Bangalore
  • Devadass P K Bangalore Medical College and Research Institute, Bangalore
Keywords: Atherosclerosis, Autopsy, Coronary Vessels, Mammary Arteries, American Heart Association classification.


Background: Coronary Artery Bypass Grafting (CABG) is one of the standard surgical procedures for treatment of multivessel Coronary Artery Disease (CAD). Among the various arterial grafts, Internal Mammary Artery (IMA) has been preferred as conduit of choice to bypass the coronary occlusion. But now with the incremental utilization of IMA grafts in CABG, there is a need for reassessment of its histological structure and presence of atherosclerosis. A prospective study was taken up to assess and correlate the prevalence of atherosclerosis in IMA and coronaries on autopsy.Methods: Representative segments of bilateral IMA and all major coronaries were taken from 150 autopsy cases conducted at Victoria hospital, Bangalore. These were processed conventionally. H&E sections of all cases were studied microscopically for presence of atherosclerosis. Morphological assessment of atherosclerotic lesions was done according to American Heart Association (AHA) classification.Results: Study included 114 males and 36 females. Atherosclerosis in IMA was seen in 11 (7.3 %) cases and coronary atherosclerosis in 122 (81.3%) cases. Prevalence of Coronary Atherosclerosis in male cases was 85.9%, while in female cases was 66.6%. LAD was the most commonly involved among coronaries. All 11 cases with IMA atherosclerosis showed coronary atherosclerosis. Higher AHA types of atherosclerosis (type 4/5) were not seen in IMA. There was no other vascular pathology apart from atherosclerosis in IMA.Conclusion: The Prevalence of atherosclerosis in IMA is on a higher side suggesting a need to look for and evaluate other conduit vessels as alternate to IMA in CABG.

Author Biographies

Suraj Jain, Bangalore Medical College and Research Institute, Bangalore
PostgraduateDepartment of Pathology
Dayananda S Biligi, Bangalore Medical College and Research Institute, Bangalore
ProfessorDepartment of Pathology
Devadass P K, Bangalore Medical College and Research Institute, Bangalore
Professor & HODDepartment of Forensic Medicine


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Original Article