Usefulness of high-frequency transthoracic Doppler echocardiography in noninvasive diagnosis of the left internal thoracic artery graft stenosis at the anastomosis.
BACKGROUND
Stenosis of the left internal thoracic artery (LITA) graft, which usually occurs at the site of the anastomosis, can be noninvasively evaluated by the flow pattern in the proximal graft, but the flow pattern is influenced by several other factors.


RESULTS
In the present study, LITA graft flow was investigated by high-frequency transthoracic Doppler echocardiography in 75 consecutive patients who underwent postoperative angiography of the LITA graft. The flow velocity was measured at both the anastomosis and proximal to it, and compared with the quantitative angiographic results. Flow at both sites was detected in 61 (81%) of the 75 patients. The diastolic velocity ratio of the anastomosis to the proximal site correlated with the percent diameter stenosis at the anastomosis. A diastolic velocity ratio >2.0 had a high sensitivity, specificity, positive predictive value and negative predictive value for the presence of significant stenosis at the anastomosis of a LITA graft.


CONCLUSIONS
High-frequency transthoracic Doppler echocardiography can be used for the noninvasive diagnosis of LITA graft stenosis.
Izumi
Chisato
C
Department of Cardiology, Tenri Hospital, Nara, Japan. izumi-ch@tenriyorozu-hp.or.jp
Takahashi
Shuichi
S
Kurozumi
Kazuyo
K
Hayashi
Hidetaka
H
Iga
Kanji
K
Miyake
Makoto
M
Himura
Yoshihiro
Y
Gen
Hiromitsu
H
Konishi
Takashi
T
D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D004452:Echocardiography; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis