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Collateralization of an occluded left internal mammary artery coronary bypass graft
Jeffrey B Geske1, Gregory W Barsness, Rajiv Gulati
1Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Insights
This case report highlights an unusual finding in coronary artery bypass grafting (CABG) angiography. A left internal mammary artery (LIMA) bypass graft maintained antegrade flow through collateral vessels despite proximal occlusion.
Area of Science:
- Cardiology
- Vascular Surgery
- Diagnostic Imaging
Background:
- The left internal mammary artery (LIMA) is a preferred arterial graft for coronary artery bypass grafting (CABG).
- Accurate assessment of LIMA graft patency and myocardial perfusion via diagnostic angiography is crucial.
- Unusual graft configurations can complicate interpretation and management.
Abstract:
The left internal mammary artery (LIMA) is frequently utilized in coronary artery bypass grafting (CABG); adequate visualization of the LIMA bypass graft during diagnostic angiography is critical for determination of myocardial blood supply. We present a novel case of angiography via a left transradial approach demonstrating an occluded LIMA coronary bypass graft with antegrade flow maintained via a collateral branch from the ipsilateral thyrocervical trunk. Given the prevalence of LIMA use in CABG, it is critical to be aware of unusual configurations, including collateralization of a proximally occluded LIMA graft as described in this report.
