The impact of ligation of proximal side branches on blood flow and functional status of the internal thoracic artery in coronary anastomosis.

Autor: Abreu JS; Public Health Department, State University of Ceará, Fortaleza, Brazil.; Prontocárdio Hospital, Fortaleza, Brazil.; Program in Cardiology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil., Tsutsui JM; Program in Cardiology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil., Falcão SN; Messejana's Heart and Lung Hospital, Fortaleza, Brazil., Feitosa JA; Prontocárdio Hospital, Fortaleza, Brazil., Rocha EA; Prontocárdio Hospital, Fortaleza, Brazil., Oliveira ÍM; Messejana's Heart and Lung Hospital, Fortaleza, Brazil., Diógenes TC; Prontocárdio Hospital, Fortaleza, Brazil., Paes JN Jr; Prontocárdio Hospital, Fortaleza, Brazil., Sbano JC; Program in Cardiology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil., Dallan LA; Program in Cardiology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil., Filho RK; Program in Cardiology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil., Mathias W Jr; Program in Cardiology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: Echocardiography (Mount Kisco, N.Y.) [Echocardiography] 2016 Nov; Vol. 33 (11), pp. 1656-1664. Date of Electronic Publication: 2016 Aug 02.
DOI: 10.1111/echo.13313
Abstrakt: Background: The effect of proximal side branches on the patency of the internal thoracic artery (ITA) is controversial. We used echocardiography and Doppler to verify the effect of ligation of branches on the flow and coronary flow reserve (CFR) of the grafted ITA in patients after coronary artery bypass grafting (CABG).
Methods: We prospectively investigated 53 patients with preserved left ventricular ejection fraction (LVEF >50%) who underwent CABG of the ITA. In Group I (25 patients), major branches were ligated during ITA anastomosis to the left anterior descending (LAD) coronary artery, whereas no ligation was performed in Group II (28 patients). Systolic flow (SF), diastolic flow (DF), and total flow (TF = SF + DF) were measured by Doppler echocardiography at the proximal level of the ITA preoperatively, at early postoperative stage, and 6 months after surgery. Dobutamine stress echocardiography (DSE) was performed at 6 months to determine CFR.
Results: The ITA flow was predominantly systolic before surgery and diastolic in the postoperative period. We found no differences between the groups in DF. On DSE, SF (19.5±9 mL/min vs 32.7±19 mL/min; P=.003) and TF (79±21 mL/min vs 101±47 mL/min; P=.037) were higher in Group II. There were no differences in CFR (1.9±0.46 vs 2.11±0.56; P=.143).
Conclusion: In patients with preserved LVEF, ligation of major side branches during anastomosis to the LAD does not alter ITA flow or CFR.
(© 2016, Wiley Periodicals, Inc.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje