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A Study Demonstrating the Quantitative Relationship Between Internal Thoracic Artery Length and Free Flow

Safa Gode1, Onur Sen1, Ersin Kadirogulları1

  • 1Departments of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.

Heart, Lung & Circulation
|September 5, 2017
PubMed

Insights

Excision of the distal left internal thoracic artery (LITA) segment improves graft flow in coronary artery bypass grafting (CABG) patients. Longer excisions of the LITA segment result in significantly greater free flow, reducing potential graft issues.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Surgery

Background:

  • The left internal thoracic artery (LITA) is crucial for coronary artery bypass grafting (CABG).
  • Inadequate LITA flow increases patient morbidity and mortality.
  • The distal LITA segment may exhibit spasmodic properties affecting graft performance.

Purpose of the Study:

  • To evaluate the impact of distal LITA segment excision on free flow in CABG patients.
  • To determine if the length of excised LITA segment influences graft flow.
  • To investigate the spasmodic potential of the distal LITA.

Main Methods:

  • 47 patients undergoing elective CABG were divided into three groups based on excised LITA length (<15mm, 15-30mm, >30mm).
  • Left ITA free flow was measured before and after distal excision.
  • Inter-group comparison of free flow differences was performed.

Main Results:

  • Mean LITA free flow differences were 27.6ml/min (group 1), 35.4ml/min (group 2), and 52.6ml/min (group 3).
  • Statistically significant differences in free flow were observed between groups (p=0.008).
  • Group 3 showed significantly higher free flow compared to groups 1 (p=0.003) and 2 (p=0.038).

Conclusions:

  • The distal LITA segment possesses a higher potential for spasm compared to other segments.
  • Spasm in the distal LITA can lead to reduced graft flow.
  • Maximizing the excision of the distal LITA segment is recommended to mitigate spasmodic effects and improve graft patency.
Abstract

Keywords:
Coronary artery bypass graftLeft internal thoracic artery free flowLeft internal thoracic artery lengthLeft internal thoracic artery spasm

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