Left internal thoracic artery graft occlusion following mediastinal radiation therapy.
Premature coronary artery disease is a late consequence of mediastinal radiation therapy. Many of these patients have been successfully treated with coronary bypass surgery. A 51-year-old man underwent bypass surgery for severe multivessel coronary disease 18 years following radiation therapy for a posterior mediastinal tumor. Recurrent angina 1 year later occurred following closure of the left internal thoracic artery graft. We suspect that this occurred as a consequence of injury sustained during mediastinal irradiation. Patients who have undergone prior mediastinal radiation therapy may not be assured the excellent long-term patency of the internal thoracic artery graft which has been reported for the general population. Saphenous vein grafts probably should be considered instead.
Schulman
H E
HE
Miriam Hospital, Brown University, Providence, RI 02906.
Korr
K S
KS
Myers
T J
TJ
D003327:Coronary Disease / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000209:etiology*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008323:Mammary Arteries / Q000528:radiation effects / Q000637:transplantation; D008479:Mediastinal Neoplasms / Q000532:radiotherapy*; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects; D012501:Saphenous Vein / Q000637:transplantation; D013997:Time Factors