Late regression of left internal thoracic artery graft stenosis at the anastomotic site without intervention therapy

Abstract

Our study demonstrated that left internal thoracic artery graft stenosis at the anastomotic site at early postoperative angiography might improve without intervention therapy. We should consider the natural course of the left internal thoracic artery graft stenosis in determining the indication of intervention therapy early after surgery.

Predictive factors for the intermediate-term patency of arterial grafts in aorta no-touch off-pump coronary revascularization

“…However, the luminal size of the side-to-side anastomosis in the sequential fashion is not precisely measurable, especially when the angle between the graft and the coronary branch is near 90 degrees, or when the contrast medium only fills incompletely due to mixture with the blood flow from the native coronary artery. Moreover, the regression of stenosis and the increase of the diameter were relatively common findings in the arterial materials [22,23]. At last, high-pressure injection of contrast medium may induce reverse and competitive flow and may interfere with evaluation of graft flow direction.…”

Graft design strategies with optimum antegrade bypass flow in total arterial off-pump coronary artery bypass

“…Additionally, the luminal size of the anastomotic site is not precisely measurable in the sequential fashion, especially when the angle of the graft and coronary branch is near to 90 degrees, or when the contrast medium dose fills only incompletely due to mixture with the blood flow from the native coronary artery. Furthermore, although inadequate surgical maneuvers during the operation strongly affect the luminal size by unsuccessful anastomosis or graft kinking, regression of the stenosis and the increase or growth of the diameter were relatively common finding in the arterial grafts [22]. Thus, we consider that the angiographic luminal size or graft patency may be not relevant for pure comparison of graft arrangement and design of the arterial conduits.…”

To intervene or not to intervene: Lessons learned from completion angiography after robotic-assisted coronary bypass surgery

“…Although the treatment of post-CABG graft failure remains poorly defined, regression of graft stenosis has been described. Izumi and colleagues 5 described patients with early graft stenosis >50% who underwent angiography at an average of 5 years post bypass, and stenosis decreased from 69% ± 13% to 35% ± 20%, suggesting that early graft imperfections in the LIMA to LAD anastomosis may improve without intervention. In the case described in this report, we assumed that this case was a technical failure, until repeat angiography showed a patent LIMA-LAD anastomosis 12 months after surgery.…”