Document Detail

Effect of distal stenosis of internal thoracic artery bypass grafts on longitudinal phasic blood flow velocity characteristics.
MedLine Citation:
PMID:  10467197     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Left internal thoracic artery (LITA) bypass conduits show gradual longitudinal transition in their phasic flow velocity patterns from the proximal to distal segments, but little is known about the influence of distal stenosis, particularly early after surgery, on that characteristic. The purpose of this study was to evaluate the influence of distal stenosis on these flow velocity patterns. METHODS: We examined 24 LITAs within 1 month (7 to 30 days) after surgery with a Doppler-tipped guide wire at the proximal, mid, and distal segments. Maximum peak velocities (MPV), time averaged peak velocities (APV), and velocity-time integrals (VTI) were measured. RESULTS: In LITAs without stenosis (n = 14, group A), the APV, MPV, and VTI values at the diastole were significantly greater than those for distal stenosis (minimal lumen diameter >75%, n = 10, group B). The values of the 3 indexes at the systole in each segment did not differ significantly between the 2 groups. Both groups showed gradual increases in the diastolic/systolic ratios of the 3 indexes from the proximal to distal portions, the ratios in group A being significantly larger than that in group B (APV, P <. 001; MPV, P <.01; TVI, P <.01, respectively). For these indexes, sensitivity and specificity for predicting stenosis of LITA was higher in the proximal and mid portion than in the distal. CONCLUSIONS: Anastomotic stenosis decreases the diastolic flow component but not the systolic one. By using diastolic/systolic ratios of the 3 indexes, it is possible to predict distal stenosis of LITA from the resting phasic flow velocity pattern.
J Koyama; M Owa; K Asakawa; H Hikita; K Ohkubo; S Ikeda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  138     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-09-22     Completed Date:  1999-09-22     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  468-76     Citation Subset:  AIM; IM    
Third Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
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MeSH Terms
Anastomosis, Surgical
Blood Flow Velocity
Constriction, Pathologic
Coronary Artery Bypass*
Coronary Circulation
Coronary Disease / pathology,  surgery*
Coronary Vessels / pathology,  surgery,  ultrasonography
Middle Aged
Thoracic Arteries / pathology,  surgery*
Vascular Patency

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