A 75-year-old woman required re-coronary artery bypass grafting due to flow insufficiency of the right internal thoracic artery (RITA). After the first operation, coronary angiography revealed a narrowed RITA. Myocardial ischemia occurred when the native coronary artery was occluded by the catheter. A stringlike internal thoracic artery is probably unable to increase blood supply immediately in response to the demand created by acute obstruction of the recipient native coronary artery.
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