{"id":14356,"date":"2026-09-15T12:40:35","date_gmt":"2026-09-15T12:40:35","guid":{"rendered":"https:\/\/www.kauveryhospital.com\/blog\/?p=14356"},"modified":"2026-09-15T12:40:35","modified_gmt":"2026-09-15T12:40:35","slug":"have-you-heard-of-bima-bypass-surgery","status":"publish","type":"post","link":"https:\/\/www.kauveryhospital.com\/blog\/heart-health\/have-you-heard-of-bima-bypass-surgery\/","title":{"rendered":"Have you heard of BIMA Bypass Surgery?"},"content":{"rendered":"

Summary<\/strong><\/h2>\n

BIMA (bilateral internal mammary artery) bypass surgery is a type of coronary artery bypass grafting (CABG) in which both internal thoracic arteries, also known as internal mammary arteries, are used as arterial grafts to improve blood flow to the heart muscle.<\/p>\n

Arterial grafts, particularly internal mammary artery grafts, have excellent long-term patency and can remain functional for many years. BIMA may therefore provide important long-term benefits for appropriately selected patients. However, using both internal mammary arteries can increase the risk of complications involving the breastbone (sternum), particularly in people with diabetes, obesity or other factors that may impair wound healing.<\/p>\n

The decision to use BIMA is individualised and depends on factors such as the patient’s age, overall health, coronary artery anatomy, status of diabetes, kidney and lung function, smoking history and risk of sternal wound complications.<\/p>\n

Following surgery, medicines, a heart-healthy diet, regular physical activity, smoking cessation and scheduled follow-up are essential for maintaining cardiovascular health.<\/p>\n

What is BIMA Bypass Surgery?\u00a0\u00a0<\/strong><\/h2>\n

Coronary artery disease occurs when fatty deposits, cholesterol and other substances like Calcium build up inside the coronary arteries. This process, known as atherosclerosis, can cause the arteries to become narrowed or blocked, reducing the supply of oxygen-rich blood to the heart muscle.<\/p>\n

When significant coronary artery blockages cannot be adequately managed with medicines or angioplasty and stenting, coronary artery bypass grafting (CABG) may be recommended<\/a>. During CABG, a healthy blood vessel from another part of the body is used to create an alternative route for blood to reach the heart muscle beyond the blocked or narrowed section.<\/p>\n

BIMA stands for bilateral internal mammary arteries<\/strong>. These are also known as the internal thoracic arteries <\/strong>and are located inside the chest.<\/p>\n

In BIMA bypass surgery, both internal mammary arteries are used as arterial grafts to bypass diseased coronary arteries. The internal mammary arteries are particularly valuable as bypass conduits because they have excellent long-term patency and are relatively resistant to the development of atherosclerosis.<\/p>\n

In many CABG procedures, the left internal mammary artery (LIMA) is used to bypass the left anterior descending (LAD) coronary artery. In BIMA surgery, the right internal mammary artery (RIMA) is also used to bypass another suitable coronary artery, depending on the patient’s coronary anatomy.<\/p>\n

BIMA is not automatically the best option for every patient. The surgeon considers the potential long-term benefits alongside the patient’s risk of complications before deciding which grafts to use.<\/p>\n

Benefits of BIMA Bypass Surgery\u00a0<\/strong><\/h2>\n

Excellent long-term durability\u00a0<\/strong><\/h3>\n

Internal mammary artery grafts are arterial grafts and have excellent long-term patency compared with saphenous vein grafts. They are less prone to developing atherosclerotic changes and narrowing over time.<\/p>\n

This durability is one of the main reasons arterial grafts are highly valued in CABG surgery.<\/p>\n

Potential long-term benefit\u00a0<\/strong><\/h3>\n

Because internal mammary artery grafts can remain open and functional for many years, BIMA may be particularly beneficial for appropriately selected patients who are expected to live for many years after surgery.<\/p>\n

However, the long-term benefits of BIMA need to be balanced against the increased risk of sternal wound complications associated with harvesting both internal mammary arteries.<\/p>\n

May reduce the need for future procedures\u00a0<\/strong><\/h3>\n

Long-lasting arterial grafts may reduce the likelihood of graft failure and the need for repeat revascularisation in some patients. However, the overall risk varies from person to person and depends on the condition of the grafts, coronary arteries and other risk factors.<\/p>\n

No vein harvesting from the leg\u00a0<\/strong><\/h3>\n

BIMA uses both internal mammary arteries<\/p>\n

It may be possible to avoid using also venous grafts harvested from the leg. This can avoid some of the discomfort, scarring and wound-related problems associated with harvesting a saphenous vein.<\/p>\n

However, other grafts may still be required during CABG depending on the number and location of coronary blockages.<\/p>\n

Also Read: Benefits and Risks of Off Pump Coronary Artery Bypass Surgery<\/a><\/div>\n

Who is a Good Candidate for BIMA Bypass?\u00a0\u00a0<\/strong><\/h2>\n

BIMA bypass is generally considered for patients who are likely to benefit from the long-term durability of two arterial grafts and who have an acceptable risk of sternal wound complications.<\/p>\n

Younger and otherwise healthy patients may be particularly suitable because they have a longer period during which the durability of arterial grafts may provide benefit.<\/p>\n

However, age alone does not rule out BIMA surgery. Similarly, conditions such as diabetes or obesity do not automatically make a patient unsuitable.<\/p>\n

The surgeon may carefully assess the following factors:<\/p>\n