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Interact CardioVasc Thorac Surg 2009;9:416-420. doi:10.1510/icvts.2008.199828
© 2009 European Association of Cardio-Thoracic Surgery

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Institutional report - Coronary

Anatomical and functional assessment of single left internal mammary artery versus arterial T-grafts 12 years after surgery

Joost M. Hartmana,*, Bob W. Meijboomb,c, Tjebbe W. Galemab, Johanna J.M. Takkenberga, Anne-Maria Schetsb, Pim J. de Feyterb,c and Ad J.J.C. Bogersa

a Department of Cardiothoracic Surgery, Thoraxcentre, Bd 575, Erasmus Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
b Department of Cardiology, Thoraxcentre, Erasmus Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
c Department of Radiology, Erasmus Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands

*Corresponding author. Tel.: +31107035412; fax: +31107033993.

E-mail address: j.m.hartman{at}erasmusmc.nl (J.M. Hartman).

We determined whether ultrasonographic left internal mammary artery (LIMA) findings correspond with 64 multislice computed tomography (MSCT) in patients 12 years after coronary artery bypass grafting. We included 34 patients (63.2±9.2 years), 16 with conventional single LIMA (group I) and 18 arterial T-grafts (group II), in a cross-sectional study. Patients underwent transthoracic proximal LIMA ultrasonography at rest and during the Azoulay maneuver, transthoracic echocardiography of the left ventricle and 64-MSCT, 11.5±1.4 years postoperatively. MSCT scans showed three string sign LIMA grafts (19%) in group I and three distal string sign LIMA grafts (17%) and 16 occluded T-graft anastomoses (22%) in group II. LIMA diameters and areas are significantly larger in group II in the origin, 3.5±0.7 vs. 2.5±0.5 mm, P=0.00007 and 0.09±0.04 vs. 0.05±0.02 cm2, P=0.00019 and in the third intercostal space, 3.4±0.7 vs. 2.5±0.5 mm, P=0.00009 and 0.09±0.03 vs. 0.05±0.02 cm2, P=0.000047. Most ultrasonographic LIMA findings do not differ between the groups. Thus, proximal LIMA diameters and areas are significantly larger in T-grafts and ultrasonographic variables equalize between the groups at rest and during the Azoulay maneuver 12 years after surgery.

Key Words: Ultrasound; Coronary artery bypass grafting; Follow-up; Computed tomography







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