OBJECTIVE: To assess the left internal thoracic artery (LITA) flow pattern, when it was used to supply the left anterior descending artery (LADA) and another branch from the left coronary artery system (LCAS). METHODS: In the following study, the left internal thoracic artery flow was investigated by echocardiography Doppler, at rest and under dobutamine stress, in two twenty-patient groups. Group A consisted of patients who received only a pedicled LITA graft to the LADA. Group B consisted of patients who received a pedicled LITA graft associated with a vein graft to supply the LADA and another artery from the LCAS. The angiographic study showed graft patency in all patients from both groups. The following parameters were used: systolic flow (SF), diastolic flow, total flow, total flow in stress/total flow at rest ratio (TFS/TFR), systolic peak velocities (SPV), diastolic peak velocities and systolic peak velocity/diastolic peak velocity ratio. RESULTS: All analysed parameters were considered statistically significant, except SF, TFS/TFR and SPV. CONCLUSIONS: We concluded that in the same conditions and methodology, the LITA flow in the composite graft (group B) is higher than in the free graft (group A), which shows the great flow adaptability of LITA to respond to flow demand.
Myocardial revascularization; Internal mammary-coronary artery anastomosis; Echocardiography, Doppler; Echocardiography, stress; Blood flow velocity
