Transient reversal of blood flow in an internal thoracic artery to coronary artery graft during syncope

1994 ◽  
Vol 17 (8) ◽  
pp. 453-455
Author(s):  
A. Mauric ◽  
N. J. Samani ◽  
D. P. De Bono
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Internal Thoracic Artery ◽  
Artery Graft

Left Internal Thoracic Artery Graft Assessment by Firefly Fluorescence Imaging for Robot-Assisted Minimally Invasive Direct Coronary Artery Bypass

2019 ◽  
Vol 14 (2) ◽  
pp. 144-150
Author(s):  
Yoshitsugu Nakamura ◽  
Miho Kuroda ◽  
Yujiro Ito ◽  
Takahiko Masuda ◽  
Shuhei Nishijima ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Minimally Invasive ◽  
Fluorescence Imaging ◽  
Coronary Artery Bypass ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Robot Assisted ◽  
Left Internal Thoracic Artery ◽  
Post Harvest

Objective The da Vinci Xi surgical system (Intuitive Surgical, Sunnyvale, CA, USA) cannot give tactile feedback to surgeons. This shortcoming may increase the risk of left internal thoracic artery (LITA) injury during its harvest. We utilized Firefly Fluorescence Imaging (Firefly) to assess LITA quality in robot-assisted minimally invasive direct coronary artery bypass (R-MIDCAB). Methods We retrospectively reviewed clinical records and intraoperative videos of 30 consecutive patients who underwent R-MIDCAB with LITA–left anterior descending (LAD) coronary bypass. All patients had post-harvest assessment of LITA blood flow by Firefly with 1 mL (2.5 mg/mL) of indocyanine green injection through a central line. Results Twenty-seven of the patients were male, mean age was 67.7 ± 10.7 years. In post-harvest assessment performed before transection of the distal LITA, blood flow in LITA was well visualized in 28 patients. In the remaining 2 patients, 1 had dissection and the other had severe spasm of the LITA. Firefly was also useful for locating LITA and LAD and for assessing blood flow of the graft after anastomosis. Time required for each Firefly assessment was approximately 20 seconds. There were no side effects or complications due to Firefly intraoperatively and postoperatively. Twenty-six patients had postoperative coronary computed tomography; LITA patency rate was 100% (26/26). Conclusion Firefly is fast, simple, and effective for locating and assessing flow in LITA and LAD before and after anastomosis in R-MIDCAB.

scholarly journals Left Internal Thoracic Artery Graft to Left Anterior Descending Coronary Artery after Blunt-Chest-Trauma Myocardial Infarction: 14-Year Outcome

2017 ◽  
Vol 44 (3) ◽  
pp. 214-218
Author(s):  
Paulo Roberto B. Evora ◽  
Minna Moreira D. Romano ◽  
Gabriela B. Tannus de Souza ◽  
Danilo T. Wada ◽  
André Schmidt ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Internal Thoracic Artery ◽  
Myocardial Revascularization ◽  
Left Internal Thoracic Artery ◽  
Artery Graft ◽  
History Of

In 2005, we reported an acute myocardial infarction secondary to a left anterior descending coronary artery injury sustained in a motorcycle accident. The treatment was late myocardial revascularization with in situ left internal thoracic artery-to-left anterior descending coronary artery anastomosis. There is little information available about the natural history of acute myocardial infarction after blunt chest trauma, especially when treated in this manner. This present communication reports the 14-year outcome in our patient.

Abstract 1564: Does Location of the Second Internal Thoracic Artery Graft Influence Outcome?

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Aleck Stockins ◽  
Joseph F Sabik ◽  
Penny L Houghtaling ◽  
Eugene H Blackstone ◽  
Bruce W Lytle
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Propensity Score ◽  
Internal Thoracic Artery ◽  
Mortality And Morbidity ◽  
System Disease ◽  
Artery Graft ◽  
Artery Disease ◽  
Propensity Score Adjustment

Objectives: To determine whether location of the second internal thoracic artery (ITA) graft used for bilateral ITA grafting affects mortality and morbidity of patients with 3-system coronary artery disease, and to identify factors associated with location of the second ITA. Methods: From 1/1972 to 6/2006, 3,611 patients with 3-system coronary artery disease underwent bilateral ITA grafting with one ITA to the left anterior descending (LAD) system and the second to either the circumflex (LCx; n=2,926) or right coronary artery (RCA; n=685) system. Follow-up was 9.2±7.2 years. Propensity score methodology was used to obtain risk-adjusted outcome comparisons between patients with the second ITA to the LCx vs RCA. Results: In-hospital mortality (0.34% vs 0.58%; P =.4), stroke (0.96% vs 0.88%; P =.8), myocardial infarction (1.3% vs 0.73%; P =.2), renal failure (0.44% vs 0.29%; P =.6), respiratory insufficiency (3.5% vs 3.8%; P =.7), and reoperation for bleeding (3.4% vs 3.2%; P =.8) were similar in patients who received the second ITA to the LCx or RCA, and remained similar after propensity score adjustment. Late survival was also similar (Fig .). Despite this, there has been a gradual decline in ITA to RCA grafting, particularly in the presence of severe LCx disease, but more use in women and in patients without RCA occlusion or distal stenoses. Conclusions: Contrary to prevailing wisdom that the second ITA graft should be anastomosed to the next most important left-sided coronary artery in 3-system disease, the second ITA graft may be placed to either the LCx or RCA system with similar early and late outcomes.

Effect of hemodialysis access blood flow on cardiac events after coronary artery bypass grafting using an internal thoracic artery

2017 ◽  
Vol 18 (4) ◽  
pp. 301-306 ◽  
Author(s):  
Leonid Feldman ◽  
Ilia Beberashvili ◽  
Ahmad Abu Tair ◽  
Shai Efrati ◽  
Oleg Gorelik ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Upper Extremity ◽  
Coronary Artery Bypass ◽  
Cardiac Death ◽  
Cardiac Event ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Cardiac Events ◽  
Risk Of Death

Background The possibility of coronary steal through an arteriovenous fistula (AVF) in hemodialysis (HD) patients with coronary artery bypass grafts (CABGs) using an ipsilateral internal thoracic artery (ITA) has been suggested. In order to define the significance of such a possibility, we analyzed cardiac events and mortality risk in patients in relation to AVF flow. Methods A retrospective cohort study was performed on prevalent HD patients from a single center. The outcomes included a first cardiac event, cardiac death and death from any cause. Results The group consisted of 23 chronic HD patients having ITA CABG and upper extremity AV access, 12 patients had an ipsilateral and 11 patients had a contralateral location of ITA CABG and an upper extremity AV access. The mean follow-up period was for 37.0 months. Multivariable Cox proportional-hazards regression analysis of risk of death from any cause in relation to AV access flow showed no increased risk, neither in the group with ipsilateral location of ITA grafts and dialysis accesses (adjusted HR, 3.047 [95% CI, 0.996 to 1.000], p = 0.081), nor in the group with contralateral location of both shunts (adjusted HR, 0.173 [95% CI, 0.997 to 1.002], p = 0.678). There was no significant correlation between AV access blood flow and the risk of first cardiac event as well as cardiac death in either study group. Conclusions In this study on HD patients having ipsilateral ITA CABG and AVF, fistula flow rate was not found to be associated with mortality or cardiac risk.

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