Internal Mammary-Coronary Artery Anastomosis

ABCIC

Case Report

Spasm of the Internal Thoracic Artery. Value of Echocardiography and Doppler in Long-term Follow-up

José Sebastião de Abreu et al. Tereza Cristina Pinheiro Diogenes Ana Gardenia L. Ponte Farias Marilia Esther Benevides Abreu … Renan Abreu Freire José Erirtônio Façanha Barreto

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ABCIC

Original Article

Ligation of the Branches of the Anastomosed Internal Thoracic Artery in the Anterior Descending Coronary Artery and the Effect on Flow Velocities and Functional Status of the Graft

José Sebastião de Abreu et al. Tereza Cristina D Pinheiro José Acácio Feitosa Marilia Esther B Abreu … Ana Gardenia L. P Farias Marcia Maria Carneiro Sandra Nívea R Falcão

Summary

Introduction

Modification of internal thoracic artery flow occurs after its anastomosis in the left anterior descending coronary artery.

Objective

To evaluate the effect of ligation of the proximal branches of anastomosed internal thoracic artery flow on the left anterior descending in relation to velocities and coronary flow velocity reserve in patients with left ventricular ejection fraction preserved (> 50%).

Methods

Prospective study of patients with left ventricular ejection fraction > 50% and revascularized. Group I was composed of 25 patients with ligation of the major branches of the internal thoracic artery flow before its anastomosis in the left anterior descending coronary artery, and Group II was composed of 28 patients without ligation. Doppler was recorded at the proximal level of internal thoracic artery flow in the preoperative, early postoperative and 6 months later. The systolic peak velocity and diastolic, and systolic mean velocity and diastolic were measured. Coronary flow velocity reserve was obtained during dobutamine stress echocardiography in postoperative period 6 months later.

Results

In the postoperative, the systolic peak velocity and the systolic mean velocity decreased while increasing the diastolic peak velocity and the diastolic mean velocity in the groups (p < 0.05). From the postoperative to the postoperative period 6 months later, only the diastolic peak velocity modified, occurring its decrease in the groups (p < 0.05). During the dobutamine stress echocardiography, diastolic peak velocity and the diastolic mean velocity increased (p < 0.05) and groups did not differ, however, the systolic peak velocity and the systolic mean velocity increased only in Group II (p < 0.05). The coronary flow velocity reserve of the groups calculated by diastolic peak velocity (Group I = 2.17 ± 0.64 and Group II = 2.28 ± 0.63) and diastolic mean velocity (Group I = 2.27 ± 0.54 and Group II = 2.5 ± 0.79) did not differ.

Conclusion

In patients with preserved left ventricular ejection fraction, the ligation of the large branches of the anastomosed internal thoracic artery flow into the left anterior descending coronary artery does not compromise the coronary flow velocity reserve, but determines limitation in the increase of the systolic velocities. (Arq Bras Cardiol: Imagem cardiovasc. 2018;31(4):231-240)

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ABC

Case Report

Coronary artery bypass surgery in patients with anomalous circumflex artery

Walter J. Gomes et al. Rodrigo P. Paez Francisco A. Alves

The anomalous origin of the circumflex artery (Cx) is uncommon and presents course variations that might make the coronary artery bypass surgery (CABG) difficult. Two patients presenting unstable angina were submitted to coronary angiography that disclosed tri-vessel disease and presence of Cx with an anomalous origin and retroaortic course with severe stenosis. Both patients underwent CABG with use of bilateral internal thoracic artery (ITA) grafts. Therefore, CABG with bilateral ITA use is feasible in cases of an anomalous origin of the Cx artery. However, this finding may constitute an additional technical setback.

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Spasm of the Internal Thoracic Artery. Value of Echocardiography and Doppler in Long-term Follow-up

Ligation of the Branches of the Anastomosed Internal Thoracic Artery in the Anterior Descending Coronary Artery and the Effect on Flow Velocities and Functional Status of the Graft

Summary

Introduction

Objective

Methods

Results

Conclusion

Coronary artery bypass surgery in patients with anomalous circumflex artery

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)