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Ann Thorac Surg 1993;55:404-409
© 1993 The Society of Thoracic Surgeons


Articles

Noninvasive hemodynamic assessment of the internal mammary artery in myocardial revascularization

Jacques A.M. van Son, MD, PhD*, Stefan H. Skotnicki, MD, Michiel B.M. Peters, MD, Nico H.J. Pijls, MD, PhD, Luc Noyez, MD, Wim N.J.C. van Asten, PhD

Clinical Vascular Laboratory, Department of Thoracic and Cardiac Surgery, and Department of Cardiology, University Hospital Nijmegen St. Radboud, Nijmegen, the Netherlands

Accepted for publication May 15, 1992.

* Address reprint requests to Dr van Son, Division of Thoracic and Cardiovascular Surgery, Mayo Clinic, Rochester, MN 55905.

Using transthoracic B-mode imaging and Doppler spectrum analysis it was found that the luminal diameter of the internal mammary artery and its hemodynamics were not significantly different among 15 preoperative patients (64 ± 10 years) who underwent myocardial revascularization using the left internal mammary artery and young and older control groups (25 ± 3 years and 61 ± 9 years, respectively). These data indicate that older age does not significantly adversely influence the degree of intimal thickening and compliance in the internal mammary artery. Doppler spectrum analysis of the internal mammary artery in the patients who were operated on revealed conversion from a triphasic systolic waveform preoperatively to a unidirectional combined systolic/ diastolic waveform at 1 week and 2 and 6 months postoperatively, characterized by a significant increase in the diastolic blood flow velocity and a significant decrease in the systolic blood flow velocity and the pulsatility and resistance indices. This study indicates that transthoracic B-mode imaging and Doppler spectrum analysis are promising noninvasive techniques in the preoperative assessment of internal mammary artery morphology and physiology. In addition, Doppler spectrum analysis can also be used in the long-term serial assessment of the internal mammary artery conduit after myocardial revascularization.




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