scholarly journals Steal of Blood Flow from the Vertebral Artery to the Internal Thoracic Artery Anastomosed to the Coronary Artery

2013 ◽  
Author(s):  
Jose Sebastião de Abreu ◽  
Nayara Lima Pimentel ◽  
Jordana Magalhães Siqueira ◽  
Carlos Newton Diógenes Pinheiro ◽  
Teresa Cristina Pinheiro Diógenes ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Vertebral Artery ◽  
Internal Thoracic Artery

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.

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.

scholarly journals Retracted: Reappraisal of the accessory internal thoracic artery

2018 ◽  
Vol 7 (2) ◽  
pp. 1304-1308
Author(s):  
Jacomay Aletta Schickerling ◽  
Kathleen Van Niekerk ◽  
Quenton Wessels ◽  
Adéle Du Plessis
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Coronary Blood Flow ◽  
Internal Thoracic Artery ◽  
Variable Structure ◽  
Mixed Race ◽  
Anatomical Structure ◽  
Initial Portion ◽  
Steal Syndrome ◽  
Coronary Artery Revascularisation

This article has been retracted by the Editor.The accessory internal thoracic artery (AITA) is a variably large branch of the initial portion of the internal thoracic artery (ITA). The AITA has been neglected as an important anatomical structure and has been identified as the culprit for the “steal-syndrome” of coronary blood flow after the use of the ITA in coronary artery revascularisation. A cadaveric study of 50 cadavers was performed to investigate the occurrence of the AITA. We found 10 (20%) out of the 50 cadavers examined, presented with AITAs either bilaterally (4%) or unilaterally (16%). Five of the eight unilateral specimens showed a left-sided appearance of the AITA. Fourteen percent of the AITAs were found in cadavers of Mixed-race (Coloured) and 6% in individuals of African descent. Knowledge of the AITA is essential for any thoracic surgeon, during the preparation of the ITA for coronary revascularisation. Data from or study supports the notion that the AITA is a highly variable structure with little correlates based on ethnicity. The AITA appear to be found more often on the left in unilateral specimens.Keywords: Accessory, Internal Thoracic artery

scholarly journals Reappraisal of the anatomy of the accessory internal thoracic artery

1970 ◽  
Vol 8 (1) ◽  
pp. 1325-1329 ◽  
Author(s):  
Jacomay Aletta Schickerling ◽  
Kathleen Van Niekerk ◽  
Quenton Wessels ◽  
Adéle Du Plessis
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Coronary Blood Flow ◽  
Internal Thoracic Artery ◽  
Variable Structure ◽  
Mixed Race ◽  
Anatomical Structure ◽  
Initial Portion ◽  
Steal Syndrome ◽  
Coronary Artery Revascularisation

The accessory internal thoracic artery (AITA) is a variably large branch of the initial portion of the internal thoracic artery (ITA). The AITA has been neglected as an important anatomical structure and has been identified as the culprit for the “steal-syndrome” of coronary blood flow after the use of the ITA in coronary artery revascularisation. A cadaveric study of 50 cadavers was performed to investigate the occurrence of the AITA. We found 10 (20%) out of the 50 cadavers examined, presented with AITAs either bilaterally (4%) or unilaterally (16%). Five of the eight unilateral specimens showed a left-sided appearance of the AITA. Fourteen percent of the AITAs were found in cadavers of Mixed-race (Coloured) and 6% in individuals of African descent. Knowledge of the AITA is essential for any thoracic surgeon, during the preparation of the ITA for coronary revascularisation. Data from this study supports the notion that the AITA is a highly variable structure with little correlates based on ethnicity. The AITA appear to be found more often on the left in unilateral specimens.Key Words: Accessory, Internal Thoracic artery

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