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J Thorac Cardiovasc Surg 1995;109:190
© 1995 Mosby, Inc.

LETTERS TO THE EDITOR

Atherosclerotic changes in the internal thoracic artery

J. Rubio-Alvarez, PhD, J. Sierra-Quiroga, PhD, D. Duran-Muñoz, PhD, J. B. Bengochea, PhD

Department of Cardiac Surgery
University Hospital
Santiago de Compostela, Spain

To the Editor:

We have read the letter by van Son and Smedts,Go 1 in which they present histologic studies of the internal thoracic artery (ITA) and suggest that "it may be beneficial not to use the distal 10% to 20% segment of the ITA because of its potentially primarily muscular content and, hence, increased tendency toward intimal thickening." We would like to present our results, which are similar to theirs.

We have done histologic studies of the more distal part of left ITA in 237 patients with coronary disease. Atherosclerosis was observed in 20 (8.4%) patients. In four (1.6%), intimal thickening was 25% to 50%. In 40 (16.8%) patients, the thickness of the intima was less than 25% of the lumen, and other abnormalities were present in eight patients.

Because of these results and those presented by van Son and Smedts, we believe that the most proximal portion possible of the ITA should be used for coronary anastomoses.

References

  1. van Son JA, Smedts F. Bifurcated ("Y") internal thoracic-coronary artery grafts [Letter]. J Thorac Cardiovasc Surg1993;106:945-6.




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