What is a potential disadvantage of IMA grafts?

• A. They are contraindicated in diabetics.
• B. They always heal without issues.
• C. They may experience healing problems in diabetics and those who are obese or have large breasts.
• D. They never have mediastinitis risk.

Answer: (C)

Internal mammary artery grafts are favored for their durability and long-term patency, but the healing of the sternotomy incision can be more challenging in some patients. Diabetes impairs wound healing through reduced microvascular circulation and slower collagen synthesis, increasing the risk of wound infection and dehiscence. Obesity adds tissue stress, makes perfusion of fatty tissue less reliable, and raises the likelihood of wound complications. Large breasts can create extra tension, moisture, and skin folds around the chest wound, further hindering healing. So, in these patient groups, a potential disadvantage of IMA grafts is an increased chance of postoperative healing problems at the incision site. The other statements aren’t correct because diabetes is not a contraindication to using IMA grafts, healing problems are not universal, and mediastinitis risk is not completely eliminated with IMA grafts.