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.