Journal of Coronary Artery Disease
Online ISSN : 2434-2173
Original Articles
Flowmetric Assessment of the Free Right Internal Thoracic Artery Anastomosed Proximally to a Saphenous Vein Graft to Revascularize the Left Coronary Artery System
Mitsuharu HosonoHiroshi YasumotoShintaro KuwauchiNaoki TaniguchiTomohiko UetsukiTakayuki OkadaShinya KanemotoNobuya ZempoNaoki MinatoKohei Kawazoe
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2020 年 26 巻 3 号 p. 57-62

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Objective: In coronary artery bypass grafting (CABG), we perform proximal anastomosis of the free right internal thoracic artery (RITA) on the hood of the saphenous vein graft (SVG) close to its aortic anastomosis. Our aim was to assess the operative results of CABG using a free RITA and the related flow measurement data. Patients and methods: We retrospectively reviewed 24 patients who underwent solitary CABG using a free RITA proximally anastomosed to a SVG. We measures graft flow after completing all anastomoses, with stable hemodynamics. We recorded the mean flow in the free RITA before and after clamping the SVG, and in the flow of SVG before and after free RITA clamping. Results: The mean (± standard deviation) number of reconstructed coronary arteries using a free RITA was 1.6 ± 0.6. Twenty-one patients underwent angiography, and all RITAs were patent. The average mean free RITA flow was 42.4 ± 18.0 mL/min. In two patients, free RITA flow was < 20 mL/min, and both patients received a free RITA individual graft for a coronary artery with low-grade proximal stenosis. We performed clamping tests in 20 patients and found no significant difference between mean flows in the free RITAs with and without SVG clamping and in the SVGs with and without free RITA clamping. Conclusion: The free RITA and SVG grafts did not affect each other regarding mean flow measurements. The proximal site of SVG is an acceptable proximal anastomotic site for a free RITA. The coronary artery with severe proximal stenosis is recommended as a target of the free RITA.

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© 2020 The Japanese Coronary Association
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