Clinical results of coronary artery bypass grafting with use of the internal thoracic artery under low free flow conditions

Citation
M. Hata et al., Clinical results of coronary artery bypass grafting with use of the internal thoracic artery under low free flow conditions, J THOR SURG, 119(1), 2000, pp. 125-129
Citations number
21
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
ISSN journal
00225223 → ACNP
Volume
119
Issue
1
Year of publication
2000
Pages
125 - 129
Database
ISI
SICI code
0022-5223(200001)119:1<125:CROCAB>2.0.ZU;2-U
Abstract
Objective: Even when left internal thoracic artery flow is very low, we hav e used the artery for grafting without any further maneuvers. In this study , we investigated the clinical results of coronary bypass surgery using the left internal thoracic artery with low free flow. Methods: A total of 163 patients were divided into 2 groups: group L (n = 43) had free flow of 20 m L/min or less and group H (n = 120) had free flow of more than 20 mL/min. W e performed a comparative study on the basis of coronary angiography and pu lsed Doppler echocardiography, Furthermore, 12 months' postoperative graft angiography was carried out in 11 patients from group L. Results: No patien t had low output syndrome or perioperative myocardial infarction, One month after the operation, 3 cases of graft occlusion and 9 cases of the "string sign" were identified in group H. However, group L had no graft occlusion and only 1 case of the "string sign." The 1-month postoperative Doppler ech ocardiographic study showed no significant differences in the diastolic fra ction of velocity time integrals and the diastolic/systolic peak velocity r atio of the grafts. In the 11 patients undergoing angiography after 1 year, graft patency was excellent. Moreover, the graft diameter was significantl y larger than it was 1 month after the operation, Conclusion: These results suggest that the left internal thoracic artery can be used for coronary ar tery bypass grafting even when the flow is less than 20 mL/min.