A Study Demonstrating the Quantitative Relationship Between Internal Thoracic Artery Length and Free Flow
HEART LUNG AND CIRCULATION, vol.27, no.7, pp.872-877, 2018 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 27 Issue: 7
- Publication Date: 2018
- Doi Number: 10.1016/j.hlc.2017.07.006
- Journal Name: HEART LUNG AND CIRCULATION
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Page Numbers: pp.872-877
- Trakya University Affiliated: No
Abstract
Background The left internal thoracic artery (LITA) is the most commonly used arterial bypass conduit in coronary artery bypass graft (CABG) patients and inadequate LITA flow can result in an increase in morbidity and mortality. In this study, we evaluated the effect of excision of the distal spasmodic segment of the LITA on the free flow in CABG patients. Methods This study consisted of 47 patients who underwent elective CABG performed with or without other cardiac surgery, between July 2015 and December 2015. Excised LITA length was shorter than 15 mm in group 1, between 15 mm and 30 mm in group 2 and longer than 30 mm in group 3. Left ITA free flow was measured for 60 seconds into a container before and after the distal LITA excision. The inter-measurement differences were calculated for the three groups. Thereafter, the comparison was performed in terms of free flow difference amongst the three groups. Results The mean difference of LITA free flow was 27.6 +/- 22.7 ml/minute in group 1, 35.4 +/- 26.7 ml/minute in group 2, and 52.6 +/- 26.1 ml/minute in group 3. There were significant differences in terms of free flow difference between the groups (p = 0.008). Also, differences were statistically significant in group 1 versus group 3 (p = 0.003) and group 2 versus group 3 (p = 0.038) in the intergroup comparisons. Conclusions The distal part of the LITA has more spasmodic potential than other segments. This spasm may result in low flow of LITA grafts. Therefore, an as long as possible excision of the distal LITA segment may be required to avoid the spasmodic effect.