Usefulness of flow reserve in the left internal mammary artery to determine graft patency to the left anterior descending coronary artery

Vineberg Procedure by "Vineberg technique modified by Lobo Filho": morbidity and mortality in the imediate post operative period, angiography results and flow analyze of the left internal thoracic artery implanted

“…In these cases, Sewell´s pedicle a structure composed of the LITA, veins and a 1.5-cm layer of endothoracic fascia, pleura and muscle would be used [26,31,32]. The Doppler echocardiograph study of the LITA has been considered, over these years, as an important noninvasive method for the evaluation of the permeability and flow of the graft [15][16][17][18][19]. Among the flow parameters investigated by means of echocardiography, the STO/ RTO ratio of the grafted LITA is considered by numerous authors as the best form of evaluating the capacity of the graft to offer an adequate blood flow in situations of increased demand, that is, in situations of metabolic stress [33][34][35].…”

“…In [15][16][17][18][19][20][21][22] Schumacher [36] published a study demonstrating the induction of angiogenesis in a ischemic human myocardium, a conduct that is increasingly being considered for patients who are not candidates for direct or percutaneous revascularization.…”

“…Aiming to develop a less invasive technique with a lower morbid-mortality rate, Lobo Filho proposed a variation of the original technique described by Vineberg [15][16][17][18][19][20][21][22] using a pacemaker lead introducing kit [14].…”

“…The Doppler echocardiograph study of the LITA linked by a pedicle to the anterior interventricular artery (AIV) has become more important over the last years as a non-invasive method to evaluate the flow and the permeability of the graft [15][16][17][18][19]. In works published between 1992 and 2001, De Simone et al [15], Chirillo et al [20], De Bono et al [21] and Van Son et al [22] demonstrated successful detection of the LITA in 100% of the cases.…”

Artéria torácica interna enxertada: patência e estado funcional em repouso e após dobutamina

“…This has been demonstrated non-invasively through the coronary reserve index (CRI), which can be obtained under different forms of stress such as the use of certain drugs (dipiridamol, adenosine, dobutamine, papaverine), a pacemaker or during exercise 4,[8][9][10][11] .…”