title: Coronary flow reserve in patients with left anterior descending artery-left internal mammary artery long patch plasty anastomosis: a prospective study.
abstract: BACKGROUND
  We aimed at assessing the efficacy of the patch plasty technique without endarterectomy in patients with diffuse coronary artery. Long anastomosis of the left internal mammary artery graft (LIMA) to the left anterior descending (LAD) artery was performed and examined using transthoracic Doppler echocardiography to detect coronary flow reserve (CFR) and epicardial stenosis.
  
  
  METHODS
  Forty-one patients (6 women; mean age, 58 ± 9 years) who underwent coronary artery bypass surgery using the patch plasty technique without endarterectomy were included in the study. Presence of CFR was examined in each patient by transthoracic Doppler echocardiography.
  
  
  RESULTS
  One of the patients (2.4%) died on the first postoperative day. The remaining patients were divided into 2 groups: those with normal CFR (CFR ≥ 2) (n = 35, 88%) and those with low CFR (CFR < 2) (n = 5, 12.0%). The length of patch plasty (3.6 ± 0.82 cm) in the low CFR group was significantly longer than that in the normal CFR group (2.69 ± 0.75 cm). Coronary angiography was performed for the 3 patients with CFR < 2: Two patients showed normal grafts and anastomoses, but the third patient's distal LAD-LIMA anastomosis was almost 90% occluded.
  
  
  CONCLUSIONS
  We elucidated the reliability of the patch plasty without endarterectomy method and transthoracic Doppler echocardiography for detecting the severity of coronary artery disease.
authors.affiliation: Department of Cardiovascular Surgery, Istanbul University Institute of Cardiology, Istanbul, Turkey. meddrog@gmail.com.
authors.forename: Ismail
authors.initials: I
authors.lastname: Haberal
authors.affiliation: Department of Cardiovascular Surgery, Hospitalium Hospitals Camlıca, Istanbul, Turkey. varisintedavisi@gmail.com.
authors.forename: Onur
authors.initials: O
authors.lastname: Gurer
authors.affiliation: Department of Cardiovascular Surgery, Istanbul University Institute of Cardiology, Istanbul, Turkey. ddoz@gmail.com.
authors.forename: Deniz
authors.initials: D
authors.lastname: Ozsoy
authors.affiliation: Department of Cardiovascular Surgery, Mersin Government Hospital, Mersin, Turkey. esraertu70@gmail.com.
authors.forename: Esra
authors.initials: E
authors.lastname: Erturk
mesh_terms: D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D016896:Treatment Outcome