title: Impact of ostial stenosis on the Doppler flow profiles in internal thoracic artery graft.
abstract: As ostial stenoses of internal thoracic artery (ITA) grafts rarely occur after coronary artery bypass grafting, little is known about their Doppler flow profile. This report describes changes in the Doppler flow of ITA grafts with ostial stenosis after surgical repair of the stenosis. A 54-year-old male underwent coronary artery bypass grafting (CABG) in which the left ITA was anastomosed to the left anterior descending coronary artery. The follow-up coronary angiography revealed an ostial 90% stenosis of the ITA. The patient underwent elective surgery during which the radial artery was interposed between the left subclavian artery and the ITA. Intraoperative ultrasonography was performed immediately before cut down of the ITA graft and again immediately after completion of all anastomoses. Both diastolic and systolic velocities and the velocity time integral increased more than 2-fold after the repair. Neither the diastolic-to-systolic peak velocity ratio nor the diastolic velocity time integral fraction showed remarkable change. These profiles were different from those reported previously for distal stenosis.
authors.affiliation: Division of Cardiovascular Surgery, National Kure Medical Center, Japan. yoshitatsu@kure-nh.go.jp
authors.forename: Masao
authors.initials: M
authors.lastname: Yoshitatsu
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Nomura
authors.forename: Hironori
authors.initials: H
authors.lastname: Izutani
authors.forename: Koichi
authors.initials: K
authors.lastname: Toda
authors.forename: Akira
authors.initials: A
authors.lastname: Katayama
authors.forename: Kentaro
authors.initials: K
authors.lastname: Tamura
authors.forename: Keijiro
authors.initials: K
authors.lastname: Katayama
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Ihara
mesh_terms: D003251:Constriction, Pathologic; D001026:Coronary Artery Bypass / Q000009:adverse effects; D004452:Echocardiography; D006083:Graft Occlusion, Vascular / Q000175:diagnosis*; D006439:Hemodynamics; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008323:Mammary Arteries / Q000601:surgery*; D008875:Middle Aged