Assessment of the hemodynamic significance of a left internal mammary artery graft-pulmonary artery shunt in a post-bypass patient using a Doppler-tipped guide wire.
We assessed the hemodynamic significance of a left internal mammary artery (LIMA) graft-pulmonary artery (PA) fistula in a post-bypass patient with chest pain. A Doppler-tipped guide wire and quantitative coronary angiography (QCA) were used to demonstrate that flow through the proximal LIMA (14.0 ml/min) was similar to the distal LIMA's contribution of flow to the left anterior descending artery (LAD) (15.6 ml/min), suggesting that the fistula was not hemodynamically significant. Therefore, intravascular Doppler and quantitative angiography may be used to assess the hemodynamic significance of a LIMA-PA fistula in a post-bypass patient.
Department of Medicine, Johns Hopkins University, Baltimore, MD 21287.
S E
SE
Reis
S T
ST
Gloth
J A
JA
Brinker
D000328:Adult; D001159:Arterio-Arterial Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D001783:Blood Flow Velocity / Q000502:physiology; D006328:Cardiac Catheterization; D017023:Coronary Angiography / Q000379:methods; D003326:Coronary Circulation / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D014465:Ultrasonics; D014463:Ultrasonography