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The mortality advantage of grafting the left internal mammary artery (LIMA) to the left anterior descending (LAD) coronary artery during conventional coronary artery bypass graft (CABG) surgery is well established. However, the exact frequency of early LIMA occlusion has ranged from 1 percent to 5 percent in small, prospective angiographic studies. In the International Multicenter Aprotinin Graft Patency Experience (IMAGE) trial, 617 (84 percent) of the 733 patients with LIMA-to-LAD anastomoses underwent follow-up angiography a median of 7 days postoperatively. Although patients who did not undergo angiography were older, there were no other significant differences between groups. A core laboratory reviewed all angiographic films, and becau…