Significance of digital subtraction angiography for estimation of early results of myocardial revascularization after internal mammary artery grafting
Hirnle, T.; Schlosser, V.; Fraedrich, G.; Kuttler, H.; Huemmler, S.; Schoenbach, B.
Kardiologia Polska 33(5): 313-319
1990
ISSN/ISBN: 0022-9032 PMID: 1981600 Document Number: 361688
Between 1st January and 31st December 1987 126 consecutive patients underwent full myocardial revascularization using at least one internal mammary artery bypass grafting in Department of Cardiovascular Surgery of University of Freiburg. In 78 patients (75 males, 3 females) DSA was performed within 8 days after surgery to evaluate dynamics of IMA-graft. The age ranged from 38 to 67 years (mean 53.4 years). DSA study was performed through the brachial artery, contrast medium was injected with flow of 10 ml/sec. in counter current. It was only one series of angiograms necessary to visualise flow from subclavian artery, through IMA to coronary artery. Among 78 investigated patients in 61 (78%) the distal anastomosis appeared to be widely patent and flow through the IMA and anastomosed coronary artery was sufficient. Patency of one of the branches of IMA or stenosis of IMA graft contributed to inadequate flow in 12 patients (15.6%). In 5 (6.4%) operated patients the IMA graft was not patent. Counter current intraarterial DSA requires much smaller amount of contrast medium than classical angiography, moreover avoiding of aortic catheterization with all risks involved. The counter current intraatrial DSA is an excellent technics of estimation of the flow to grafted coronary arteries. The method is easy to perform, repetitive and carry very small risk for the patient. Early postoperative evaluation of IMA-graft patency is essential for estimation of effectiveness of myocardial revascularisation and prognosis for the patient.