Doppler echocardiographic criteria in patency assessment of composite grafts from left internal thoracic artery.

Objectives: The purpose of our study was to establish, with an entirely noninvasive method, transthoracic Doppler echocardiography, criteria for patency of composite left internal thoracic artery grafts when placed on the left anterior descending artery and other branches of the left coronary system.

Methods: The control group comprised 20 patients with single graft and 20 patients with composite graft; all forty having their patency confirmed by coronary angiogram (CA). In this control group, two Doppler echocardiographic variables, diastolic mean velocity-time and integral diastolic peak velocity to systolic peak velocity ratio were recorded.

Right coronary revascularization using the right internal thoracic artery in situ with persisting side branches.

There is a controversy about flow steal when the internal thoracic artery is used, with its remnant branches, to revascularize the coronary system. We report a case of a 64-year-old man who was submitted to revascularization using an in situ right internal thoracic artery, with persisting side branches, to supply the right coronary system. Angiography, Doppler echocardiography, and echocardiography at rest and under stress were performed.

Flow analysis of left internal thoracic artery in myocardial revascularization surgery using y graft.

In order to evaluate the left internal thoracic artery flow pattern, when the vessel is used as a graft to supply the left coronary artery system, we evaluated flow by Doppler measurement, both at rest and under dobutamine stress. There were 2 groups of 20 patients each: group A patients received only a left internal thoracic artery graft to the left anterior descending artery, and group B patients received a pedicled left internal thoracic artery graft associated with a vein graft, which together supplied the left anterior descending artery and another branch of the left coronary artery. Angiography showed patent grafts in all patients from both groups.

Vineberg's procedure modified technique: flow analysis, immediate postoperative results and angiographic evaluation.

Background: The purpose of this study was to evaluate angiographic results of patients subjected to a technique variation of Vineberg's procedure, as well as their morbidity and mortality in immediate postoperative period, and to analyze the flow of grafted left internal thoracic artery (LITA) at rest and under stress.

Methods: Between September 1999 and April 2002 eight patients were operated upon, with implant of the internal thoracic artery (ITA) in the intimal layer of the left ventricle (LV) muscle. After 6 months, they underwent angiographic and Doppler evaluation.