title: Late regression of left internal thoracic artery graft stenosis at the anastomotic site without intervention therapy.
abstract: OBJECTIVE
  Intervention therapy has been recently performed on the left internal thoracic artery graft stenosis. The purpose of this study was to evaluate the natural course of the left internal thoracic artery graft stenosis at the anastomotic site and clarify whether intervention therapy should be performed early after surgery.
  
  
  METHODS
  We investigated early angiographic results of the left internal thoracic artery graft in 343 consecutive patients who underwent coronary bypass surgery. In 100 of 343 patients who underwent follow-up angiography, the graft diameter and percentage diameter stenosis at the anastomotic site were compared between early postoperative and follow-up angiography. None of these patients underwent intervention therapy on the left internal thoracic artery graft.
  
  
  RESULTS
  Of 343 patients, 46 showed 50% or greater diameter stenosis, and 20 showed 70% or greater diameter stenosis at the anastomotic site. In the 100 patients with follow-up angiography, the graft diameter significantly increased (1.8 +/- 0.4 vs 2.1 +/- 0.5 mm, P < .0001) at follow-up angiography. The percentage diameter stenosis significantly decreased (69% +/- 13% vs 35% +/- 20%, P < .0001) at follow-up angiography in the patients with 50% or greater diameter stenosis at early postoperative angiography. Regression of left internal thoracic artery graft stenosis was detected in most patients with 70% or greater diameter stenosis.
  
  
  CONCLUSIONS
  Our study demonstrated that left internal thoracic artery graft stenosis at the anastomotic site at early postoperative angiography might improve without intervention therapy. We should consider the natural course of the left internal thoracic artery graft stenosis in determining the indication of intervention therapy early after surgery.
authors.affiliation: Department of Cardiology, Tenri Hospital, Nara, Japan. izumi-ch@tenriyorozu-hp.or.jp
authors.forename: Chisato
authors.initials: C
authors.lastname: Izumi
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Hayashi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ueda
authors.forename: Masahiko
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Himura
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Gen
authors.forename: Takashi
authors.initials: T
authors.lastname: Konishi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000601:surgery / Q000637:transplantation*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011859:Radiography; D012075:Remission, Spontaneous; D013997:Time Factors