First Report of No-React Bovine Internal Mammary Artery Performance and Patency


  • Shekar L. C. Reddy
  • Jain Pillai
  • Leslie Mitchell
  • Sudhir Naik
  • John Dark
  • Asif Hasan
  • Simon Ledingham
  • Stephen C. Clark



Background: No-React treatment is known to render tissues resistant to calcific degeneration and to reduce early inflammatory response. No-React bovine internal mammary artery (NR-IMA) is available for restricted use in Europe. In this first study, our aim was to use magnetic resonance imaging (MRI) to investigate the clinical performance and patency rates of this conduit.

Methods: Seven patients received 8 grafts with NR-IMA. Approval from the Medical Devices Agency of the United Kingdom was obtained for use of this material. One patient needed salvage coronary artery bypass grafting (CABG). Graft patency was investigated with cardiac MRI. One patient was excluded from the MRI study because of the presence of intracerebral metal clips. The mean follow-up period was 2.5 years with a range of 1 to 4.5 years.

Results: There was no mortality in this group. After treatment 6 patients were asymptomatic, and 1 patient had class II anginal symptoms. Four (57%) of the 7 NR-IMA grafts remained patent. The longest patency was 4.5 years in a patient who underwent salvage CABG. Other associated grafts in this cohort of patients were 5 left internal mammary arteries (all patent), 1 radial artery graft (patent), and 7 saphenous vein grafts (4 [57%] of 7 patent). There were no occluded NR-IMA grafts in a patient with patent vein grafts.

Conclusion: We concluded that at 2.5 year follow-up, NR-IMA had a patency rate of 57% (4 of 7 cases). This rate matched the vein graft patency rate in this cohort of patients. With the longest patency of 4.5 years, use of NR-IMA seems to hold promise for the future.


Abolhoda A, Yu S, Oyarzun JR, et al. 1996. No-React detoxification process: a superior anticalcification method for bioprostheses. Ann Thorac Surg 62:1724-30.nAbolhoda A, Yu S, Oyarzun JR, McCormick JR, Bogden JD, Gabbay S. 1996. Calcification of bovine pericardium: glutaraldehyde versus No-React biomodification. Ann Thorac Surg 62:169-74.nDavies MG, Hagen PO. 1995. Pathophysiology of vein graft failure: a review. Eur J Vasc Endovasc Surg 9:7-18.nGabbay S, Chuback MS, Khavarian C, Donahoo J, Oyarzum R, Scoma R. 1994. In vitro and animal evaluation with the Biocor No-React anticalcification treatment for bioprosthesis (new concepts in anticalcification treatment). In: Gabbay S, Frater WM, eds. New Horizons and the Future of Heart Valve Bioprostheses. Austin, TX: Silent Partner; 74-82.nGaljee MA, van Rossum AC, Doesburg T, van Eenige MJ. 1996. Value of magnetic resonance imaging in assessing patency and function of coronary artery bypass grafts: an angiographically controlled study. Circulation 93:660-6.nMarianeschi SM, Iacona GM, Seddio F, et al. 2001. Shelhigh No-React porcine pulmonic valve conduit: a new alternative to the homograft. Ann Thorac Surg 71:619-23.nO'Brien TK, Gabbay S, Parkes AC, Knight RA, Zalesky PJ. 1984. Immunological reactivity to a new glutaraldehyde tanned bovine pericardial heart valve. Trans Am Soc Artif Intern Organs 30:440-4.n



How to Cite

Reddy, S. L. C., Pillai, J., Mitchell, L., Naik, S., Dark, J., Hasan, A., Ledingham, S., & Clark, S. C. (2005). First Report of No-React Bovine Internal Mammary Artery Performance and Patency. The Heart Surgery Forum, 7(5), E446-E449.




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