[Short- and medium-term study of arterial grafts and native coronary circulation after in situ implant of the internal mammary artery].
The internal mammary artery (IMA) is being increasingly utilized as a conduit for myocardial revascularization, based on its higher long-term patency. The aim of this study is the serial assessment of the changes of native coronary vessels after IMA coronary anastomosis. Twenty-six consecutive patients (24 males and 2 females, mean age 56.4 years) received an IMA graft on the left anterior descending (LAD) artery. IMA coronary anastomosis was single in 11 patients and double (LAD and diagonal branch) in the remaining 15 cases. In 23 patients (88.5%) at least one associated saphenous vein graft was inserted. Post-operatively, no new Q waves or low-output syndromes were observed. Follow-up angiographic study, including selective opacification of the IMA graft, was carried out after 1 month and after 1 year. The cumulative patency rate of IMA grafts was 97.7% after 1 month. The LAD stenosis proximal to the IMA anastomosis progressed to total occlusion in 6 patients (28.5%), all of them with a preoperative stenosis ranging from 90 to 99%; its diameter remained unchanged in 6 patients (28.5%), while a reduction of the coronary narrowing greater than or equal to 20% was observed in 9 patients (43%). Preoperatively, the LAD stenosis of the latter groups ranged from 70 to 90%. Severity of residual stenosis and relative diameters of LAD artery and IMA graft influenced the competitive flow distribution through these vessels.(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011859:Radiography; D013997:Time Factors; D014654:Vascular Patency
Studio a breve e medio termine dei graft arteriosi e del circolo coronarico nativo dopo impianto di arteria mammaria interna in situ.