Clinical results of coronary artery bypass grafting with use of the internal thoracic artery under low free flow conditions
| Autor: | Tomonori Yamamoto, Shun-ichi Kimura, Hiroaki Hata, Motomi Shiono, Eise Yokoyama, Yukiyasu Sezai, Shinsuke Choh, Satoshi Kashiwazaki, Haruhiko Okumura, Yukihiko Orime, Shinya Yagi, Nanao Negishi, Mitsumasa Hata, Akira Sezai |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Diastole Coronary Disease Internal thoracic artery Coronary Angiography Thoracic Arteries Risk Factors Internal medicine medicine.artery medicine Humans Myocardial infarction Derivation Coronary Artery Bypass Vascular Patency Echocardiography Doppler Pulsed Chi-Square Distribution medicine.diagnostic_test business.industry Graft Occlusion Vascular Hemodynamics Perioperative Middle Aged medicine.disease Surgery medicine.anatomical_structure Treatment Outcome Bypass surgery Pulsatile Flow Angiography Cardiology Female business Cardiology and Cardiovascular Medicine Blood Flow Velocity Artery |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 119(1):125-129 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/s0022-5223(00)70226-1 |
| Popis: | Objective: Even when left internal thoracic artery flow is very low, we have 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 mL/min or less and group H (n = 120) had free flow of more than 20 mL/min. We performed a comparative study on the basis of coronary angiography and pulsed Doppler echocardiography. Furthermore, 12 months' postoperative graft angiography was carried out in 11 patients from group L. Results: No patient 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 echocardiographic study showed no significant differences in the diastolic fraction of velocity time integrals and the diastolic/systolic peak velocity ratio of the grafts. In the 11 patients undergoing angiography after 1 year, graft patency was excellent. Moreover, the graft diameter was significantly larger than it was 1 month after the operation. Conclusion: These results suggest that the left internal thoracic artery can be used for coronary artery bypass grafting even when the flow is less than 20 mL/min. (J Thorac Cardiovasc Surg 2000;119:125-9) |
| Databáze: | OpenAIRE |
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