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The Journal of Thoracic and Cardiovascular Surgery, Vol 104, 1532-1538, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
T Seki, S Kitamura, K Kawachi, R Morita, T Kawata, K Mizuguchi, J Hasegawa, Y Kameda and Y Yoshida
We used quantitative angiography to determine the postoperative diameter of
the internal thoracic artery graft at the point close to the anastomosed
site in 147 patients who received the graft for the left anterior
descending coronary artery. We performed generalized multiple linear
regression analysis (Type I quantification method) to assess the effects of
the following factors on the internal thoracic artery graft diameter: age,
gender, time of angiography, laterality of the internal thoracic artery
used, presence of an undivided major side branch of the internal thoracic
artery, presence of a saphenous vein graft having blood flow competition
with an internal thoracic artery graft, presence of distal stenosis of the
recipient left anterior descending coronary artery, severity of
postoperative left anterior descending coronary artery stenosis, and
presence of coronary risk factors. The standardized category scores for 25%
left anterior descending coronary artery stenosis, 50% left anterior
descending coronary artery stenosis, and presence of a saphenous vein graft
having blood flow competition with an internal thoracic artery graft were -
1.418, -0.767 and -0.622, respectively. Thus, the internal thoracic artery
diameter was smaller in patients with well-preserved flow of the recipient
coronary artery. The internal thoracic artery diameter had a particularly
strong correlation with the degree of left anterior descending coronary
artery stenosis (partial correlation coefficient: 0.670). The other factors
seemed to have little or no correlation with the postoperative internal
thoracic artery diameter. With the criterion that the internal thoracic
artery diameter below 1.0 mm represents the "string sign" of internal
thoracic artery graft, this phenomenon was observed in nine patients
(6.1%). In all of these patients, left anterior descending coronary artery
flow was well-preserved, and no ischemia was disclosed in the left anterior
descending coronary artery- perfused area. These results indicate that
internal thoracic artery grafts have flow adaptability responding to the
flow demand of the recipient coronary artery and that the string sign of
internal thoracic artery grafts is mainly an outcome of its physiologic
characteristics.
ARTICLES
A quantitative study of postoperative luminal narrowing of the internal thoracic artery graft in coronary artery bypass surgery
Department of Surgery III, Nara Medical College, Japan.
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T. Hirotani, T. Kameda, S. Shirota, and Y. Nakao An evaluation of the intraoperative transit time measurements of coronary bypass flow Eur. J. Cardiothorac. Surg., June 1, 2001; 19(6): 848 - 852. [Abstract] [Full Text] [PDF]
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T. Sasajima, V. Bhattacharya, M. Hong-De Wu, Q. Shi, N. Hayashida, and L. R. Sauvage Morphology and histology of human and canine internal thoracic arteries Ann. Thorac. Surg., July 1, 1999; 68(1): 143 - 148. [Abstract] [Full Text] [PDF]
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G. Tavilla, N. H.J. Pijls, E. Berreklouw, and K. H. Peels Noninvasive assessment of right gastroepiploic artery graft patency using transcutaneous color Doppler echocardiography Ann. Thorac. Surg., March 1, 1999; 67(3): 624 - 628. [Abstract] [Full Text] [PDF]
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S. Noda and H. B. Barner Arterial conduits Ann. Thorac. Surg., January 1, 1999; 67(1): 285 - 286. [Full Text] [PDF]
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P. K. Spanos, A. D. Bisbos, and I. I. Arditis Treatment of internal thoracic artery steal syndrome withsupraclavicular approach J. Thorac. Cardiovasc. Surg., February 1, 1998; 115(2): 464 - 465. [Full Text]
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A. H. Chen, T. Nakao, R. F. Brodman, M. Greenberg, R. Charney, M. Menegus, M. Johnson, R. Grose, R. Frame, E. C. Hu, et al. EARLY POSTOPERATIVE ANGIOGRAPHIC ASSESSMENT OF RADIAL ARTERY GRAFTS USED FOR CORONARY ARTERY BYPASS GRAFTING J. Thorac. Cardiovasc. Surg., June 1, 1996; 111(6): 1208 - 1212. [Abstract] [Full Text]
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J. J. Han, Y. T. Lee, Y. K. Park, S. N. Hong, and S. H. Kim Left Subclavian Artery Bypass Graft in Complicated Arterial Switch Operation Ann. Thorac. Surg., May 1, 1996; 61(5): 1523 - 1525. [Abstract] [Full Text]
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H. Takemura, M. Kawasuji, N. Sakakibara, T. Tedoriya, T. Ushijima, and Y. Watanabe Internal Thoracic Artery Graft Function During Exercise Assessed by Transthoracic Doppler Echography Ann. Thorac. Surg., March 1, 1996; 61(3): 914 - 919. [Abstract] [Full Text]
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M. Buche, E. Schroeder, O. Gurne, P. Chenu, J.-L. Paquay, B. Marchandise, P. Eucher, Y. Louagie, R. Dion, J.-C. Schoevaerdts, et al. Coronary artery bypass grafting with the inferior epigastric artery: Midterm clinical and angiographic results J. Thorac. Cardiovasc. Surg., March 1, 1995; 109(3): 553 - 560. [Abstract] [Full Text]
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M. Nasu, T. Akasaka, T. Okazaki, M. Shinkai, H. Fujiwara, J. Sono, Y. Okada, S. Miyamoto, S. Nishiuchi, J. Yoshikawa, et al. Postoperative Flow Characteristics of Left Internal Thoracic Artery Grafts Ann. Thorac. Surg., January 1, 1995; 59(1): 154 - 162. [Abstract] [Full Text]
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H. Nishida, M. Endo, H. Koyanagi, T. Koyanagi, and K. Nakamura Coronary artery bypass grafting with the right gastroepiploic artery and evaluation of flow with transcutaneous Doppler echocardiography J. Thorac. Cardiovasc. Surg., September 1, 1994; 108(3): 532 - 539. [Abstract] [Full Text]
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