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Evaluation of the thoracodorsal artery as an alternative conduit for coronary bypass
H Moro1, H Ohzeki, J I Hayashi
1Second Department of Surgery, Niigata University School of Medicine, Japan.
Insights
The left thoracodorsal artery (LTDA) shows promise as a new arterial graft for coronary bypass surgery. Its size and histological properties suggest it could be a viable alternative when other grafts are unavailable.
Area of Science:
- Cardiovascular Surgery
- Vascular Grafting
- Thoracic Surgery
Background:
- Arterial grafts are preferred for complete coronary revascularization due to superior patency rates.
- Repeat coronary bypass surgery presents challenges in finding suitable arterial conduits.
- The left thoracodorsal artery (LTDA) is explored as a potential alternative bypass graft.
Purpose of the Study:
- To evaluate the anatomical and histological characteristics of the left thoracodorsal artery (LTDA) for potential use as a coronary arterial graft.
Main Methods:
- Angiographic measurements of LTDA length, diameter, and branching in 16 patients.
- Intraoperative measurement of LTDA in situ blood flow and external diameter in 8 patients.
- Histological evaluation of LTDA specimens compared to internal thoracic artery (ITA) and inferior epigastric artery (IEA).
Main Results:
- Angiographically, the LTDA demonstrated a similar diameter to the internal thoracic artery (ITA).
- Histological examination revealed that the LTDA shares characteristics with the inferior epigastric artery (IEA).
- Intraoperative measurements provided data on LTDA blood flow and diameter.
Conclusions:
- The left thoracodorsal artery (LTDA) possesses suitable anatomical and histological properties for consideration as a coronary arterial graft.
- LTDA may serve as a valuable alternative conduit, particularly in cases requiring repeat coronary bypass surgery.
Abstract:
Complete coronary revascularization using arterial grafts has been performed recently because of their improved patency rates. However, as the need to repeat coronary bypass surgery has become more frequent, it can be difficult to find adequate conduits for further bypass surgery. Therefore, we investigated the use of the left thoracodorsal artery (LTDA) as an alternative bypass conduit. The length from its origin, internal diameter, and number and location of branches were angiographically measured in 16 patients, and in situ blood flow volume and external diameter were intraoperatively measured in 8. Moreover, each specimen of the LTDA, the internal thoracic artery (ITA), and the inferior epigastric artery (IEA) were evaluated histologically. We found that the thoracodorsal artery has the same diameter as the ITA angiographically, and the same histological findings as the IEA. In conclusion, the thoracodorsal artery may be useful as a coronary arterial graft.