The roots of current day coronary artery bypass graft surgery (CABG) date back towards the end of 18th century. In 1899, Francois Franck proffered
the first surgical treatment for angina pectoris. He believed that ligation of sympathetic pain pathways would result in relief of angina. The internal
mammary artery (IMA) formed an area of interest early on, particularly after the report of Fieschi in 1939. He ligated the right IMA at the second
intercostal space to increase blood flow to the coronary circuit through smaller anastomotic collaterals from the IMA bed. It was not until the
work by Arthur Vineberg in 1946 that the use of the IMA was starting to show promising results. He skeletonized the left IMA and tunneled the
artery next to the left anterior descending (LAD) coronary artery.
Author(s): G Ramasubramanyam