Coronary Artery Bypass with Low Free Flow Internal Thoracic Artery / 日本心臓血管外科学会雑誌

ABSTRACT

It has been reported that the left internal thoracic artery (LITA) should be used for CABG when its free flow is more than 40-80ml/min. In the past 6 years, 120 cases of CABG have been performed in our institution. In 71 of these 120 cases, LITA was anastomosed to the left anterior descending coronary artery (LAD). These 71 cases can be divided into the following two groups Group L consists of 14 cases, in which LITA-FF was less than 20ml/min. Group H consists of 57 cases, in which LITA-FF was 21ml/min or more. In all cases, LITA was dissected by electrocauterization. Papaverine administration and balloon dilation of LITA were not employed. We performed a comparison study between the groups based on post operative coronary angiographic findings. In group H, LITA graft occlusion was identified in 3 cases, and “string sign” in 7 cases. In group L, “string sign” was identified in only 1 case, and there was no LITA graft occlusion. There was no significant difference between the two groups. Satisfactory results of early graft patency were achieved as follows 94.7% in group H, 100% in group L. These results suggest that LITA can be used for CABG, even when the free flow is less than 20ml/min.