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A Study Demonstrating the Quantitative Relationship Between Internal Thoracic Artery Length and Free Flow - 30/05/18

Doi : 10.1016/j.hlc.2017.07.006 
Safa Gode, MD a, , Onur Sen, MD a, Ersin Kadirogulları, MD a, Adem Reyhancan, MD a, Mugisha Kyaruzi, MD a, Muhammet Hulusi Satılmısoglu, MD b, Korhan Erkanlı, MD a
a Departments of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey 
b Departments of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey 

Corresponding author at: Mehmet Akif Ersoy Thoracic and Cardiovascular Training and Research Hospital Cardiovascular Surgery Department, Turgut Özal Bulvarı No:11 34000 Küçükçekmece, Istanbul, Turkey. Tel.: +90 532 603 73 46, Fax: 212 471 94 94.Mehmet Akif Ersoy Thoracic and Cardiovascular Training and Research Hospital Cardiovascular Surgery DepartmentTurgut Özal Bulvarı No:11 34000 Küçükçekmece, Istanbul, Turkey. Tel.: +90 532 603 73 46, Fax: 212 471 94 94

Resumen

Background

The left internal thoracic artery (LITA) is the most commonly used arterial bypass conduit in coronary artery bypass graft (CABG) patients and inadequate LITA flow can result in an increase in morbidity and mortality. In this study, we evaluated the effect of excision of the distal spasmodic segment of the LITA on the free flow in CABG patients.

Methods

This study consisted of 47 patients who underwent elective CABG performed with or without other cardiac surgery, between July 2015 and December 2015. Excised LITA length was shorter than 15mm in group 1, between 15mm and 30mm in group 2 and longer than 30mm in group 3. Left ITA free flow was measured for 60seconds into a container before and after the distal LITA excision. The inter-measurement differences were calculated for the three groups. Thereafter, the comparison was performed in terms of free flow difference amongst the three groups.

Results

The mean difference of LITA free flow was 27.6±22.7ml/minute in group 1, 35.4±26.7ml/minute in group 2, and 52.6±26.1ml/minute in group 3. There were significant differences in terms of free flow difference between the groups (p=0.008). Also, differences were statistically significant in group 1 versus group 3 (p=0.003) and group 2 versus group 3 (p=0.038) in the intergroup comparisons.

Conclusions

The distal part of the LITA has more spasmodic potential than other segments. This spasm may result in low flow of LITA grafts. Therefore, an as long as possible excision of the distal LITA segment may be required to avoid the spasmodic effect.

El texto completo de este artículo está disponible en PDF.

Keywords : Left internal thoracic artery free flow, Coronary artery bypass graft, Left internal thoracic artery length, Left internal thoracic artery spasm


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© 2017  Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 27 - N° 7

P. 872-877 - juillet 2018 Regresar al número
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