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Effect of graft adaptation of the internal mammary artery on longitudinal phasic blood flow velocity characteristics after surgery.

Authors
  • Kumazaki, Setsuo
  • Koyama, Jun
  • Aizawa, Kazunori
  • Kasai, Hiroki
  • Koshikawa, Megumi
  • Izawa, Atsushi
  • Tomita, Takeshi
  • Takahashi, Masafumi
  • Ikeda, Uichi
Type
Published Article
Journal
Heart and Vessels
Publisher
Springer-Verlag
Publication Date
Nov 01, 2010
Volume
25
Issue
6
Pages
515–521
Identifiers
DOI: 10.1007/s00380-010-0015-2
PMID: 20922536
Source
Medline
License
Unknown

Abstract

Left internal mammary artery (LIMA) bypass conduits undergo gradual longitudinal flow transition from the proximal to distal segments, and the diastolic/systolic (D/S) ratios of the flow indices can diagnose graft patency. However, the influence of graft adaptation on this has not been studied. We examined 46 patients with LIMA graft to the left anterior descending artery using a Doppler-tipped guidewire in the proximal, middle, and distal segments; 34 had patent LIMAs (group A: new LIMAs; <1 month postoperatively; n = 22 and group B: old LIMAs; ≥1 month postoperatively; n = 12), and 12 had new LIMAs with distal stenosis (group C). In diastole, the time-averaged peak velocities, maximum peak velocities, and velocity-time integrals in each segment were significantly greater in group A than in groups B or C; however, in systole, they did not differ significantly among the three groups. The D/S ratios of the indices in all segments in group A were significantly greater than those in groups B or C; however, they did not differ between groups B and C in any of the segments. Graft adaptation of a patent LIMA, itself, affects the longitudinal flow transition pattern. The D/S ratio of the three indices in the patent old LIMAs did not differ from those in the LIMAs with distal stenosis early after surgery. The timing of LIMA flow assessment must be considered during assessment of the graft patency from the flow velocity patterns.

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