Document Detail


Should use of the internal thoracic artery be avoided under conditions of low free flow? Postoperative hemodynamic assessment using pulsed Doppler echocardiography.
MedLine Citation:
PMID:  10462020     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There are cases in which it is thought advisable to avoid the use of the left internal thoracic artery (LITA) in coronary artery bypass grafting (CABG) due to its low free flow (FF). However, even though the LITA flow is very low, anastomosis without any further maneuvers intraluminally is recommended. The present study investigated the clinical results of CABG, using a LITA with low FF. The 60 cases of CABG were divided into 2 groups: (i) Group L (n = 23), in which LITA FF was less than 20 ml/min; and (ii) Group H (n = 37) in which it was more than 20 ml/min. A comparative study on the basis of coronary angiography and pulsed Doppler echocardiography was performed. In both groups, no LITA graft occlusion was identified, and the 'string sign' was also absent. In the LITA blood waveform, all cases exhibited a biphasic pattern with a higher mid-diastolic and a lower end-systolic component. There were no significant differences in the LITA flow diastolic peak velocity, velocity time integrals and the diastolic/systolic peak velocity ratios. These results suggest that the LITA can be used for CABG even when the free flow is less than 20 ml/min.
Authors:
M Hata; M Shiono; Y Orime; H Hata; S Yagi; T Yamamoto; S Tsukamoto; H Okumura; S Kimura; A Sezai; S Kashiwazaki; S Choh; N Negishi; Y Sezai; N Tanigawa; A Shindoh
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Japanese circulation journal     Volume:  63     ISSN:  0047-1828     ISO Abbreviation:  Jpn. Circ. J.     Publication Date:  1999 Jul 
Date Detail:
Created Date:  1999-10-08     Completed Date:  1999-10-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7806868     Medline TA:  Jpn Circ J     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  533-6     Citation Subset:  IM    
Affiliation:
Second Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Flow Velocity / physiology
Coronary Angiography / methods
Coronary Artery Bypass / adverse effects
Coronary Disease / surgery
Echocardiography, Doppler, Pulsed / methods
Female
Graft Occlusion, Vascular
Hemodynamics / physiology
Humans
Male
Middle Aged
Postoperative Period
Risk Factors
Thoracic Arteries / transplantation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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