title: Massive alterations of the left internal thoracic artery late after repair for aortic coarctation.
abstract: Adhesions or unattended injury are known but are seldom reasons to prevent withdrawing the use of the left internal thoracic artery during coronary artery bypass grafting. The patient in this case report was a 68-year-old man, who had undergone repair for aortic coarctation 34 years prior to coronary artery bypass grafting. After left internal thoracic artery harvesting, a no-flow situation of the graft was present. Transection of the graft revealed massive atherosclerotic alterations. To avoid unnecessary left internal thoracic artery harvesting, preoperative imaging in terms of a left internal thoracic artery angiography during coronary angiography is mandatory. The fact of finding massive alterations decades after pressure reduction indicates that relief from shear stress is not necessarily combined with remodeling of vascular alterations.
authors.affiliation: Department for Thoracic and Cardiovascular Surgery, University of Essen, Essen, Germany. brigitte.osswald@uk-essen.de
authors.forename: Brigitte R
authors.initials: BR
authors.lastname: Osswald
authors.forename: Stefan
authors.initials: S
authors.lastname: Knipp
authors.forename: Ingo
authors.initials: I
authors.lastname: Wiese
authors.forename: Heinz G
authors.initials: HG
authors.lastname: Jakob
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000601:surgery*; D000368:Aged; D001017:Aortic Coarctation / Q000175:diagnosis / Q000601:surgery*; D001161:Arteriosclerosis / Q000473:pathology*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D018570:Risk Assessment; D012501:Saphenous Vein / Q000637:transplantation*; D012720:Severity of Illness Index; D013895:Thoracic Arteries / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000379:methods