HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Charles C. Canver Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Canver, C. C. Articles by Nichols, R. D. Search for Related Content PubMed PubMed Citation Articles by Canver, C. C. Articles by Nichols, R. D.

Ann Thorac Surg 1997;63:1041-1043
© 1997 The Society of Thoracic Surgeons

---

Original Article: Cardiovascular

Assessment of Internal Thoracic Artery Vasoreactivity in Response to Sublingual Nitroglycerin

Section of Cardiothoracic Surgery, William S. Middleton Memorial Veterans Hospital, University of Wisconsin School of Medicine, Madison, Wisconsin

Accepted for publication October 28, 1996.

Background. We have previously shown the feasibility of assessing internal thoracic artery (ITA) size and blood flow hemodynamics before and after coronary artery bypass grafting using color-flow duplex ultrasound. This noninvasive method would be an ideal diagnostic tool for the evaluation of ITA graft status after therapeutic interventions in a patient with angina after coronary artery bypass grafting. The purpose of this study was to investigate the effects of nitroglycerin on the diameter and blood flow velocities of the left native ITA before coronary artery bypass grafting and the ITA graft postoperatively.

Methods. The study consisted of 24 male patients (mean age, 59 ± 2.3 years) who had undergone elective coronary artery bypass grafting using a left ITA graft to the left anterior descending artery, with additional saphenous vein grafts. Color-flow duplex ultrasound (5.0-MHz transducer) was used for both the preoperative imaging of native ITAs and the postoperative study of ITA grafts before patient discharge. Repeated-measures analysis of variance was used to compare measurements of the ITA size and flow velocities (peak systolic velocity and end-diastolic velocity) at 5, 10, and 15 minutes after a single dose of sublingual nitroglycerin (0.4 mg) with the baseline values obtained without nitroglycerin.

Results. The preoperative native left ITA and the postoperative left ITA graft diameters responded to sublingual nitroglycerin by showing a rapid and significant increase beginning at 5 minutes and lasting up to 15 minutes (p = 0.0001). Sublingual nitroglycerin caused the peak systolic velocity of the native left ITA to be augmented at 5 minutes (p = 0.0002), and this effect was still apparent at 10 minutes (p = 0.0001) and 15 minutes (p = 0.0192). However, postoperative left ITA graft peak systolic velocities remained unaffected by the sublingual nitroglycerin (p = not significant).

Conclusions. We conclude that instantaneous noninvasive measurement of ITA graft size and blood flow velocities after a therapeutic drug intervention may be clinically useful, particularly in a post–coronary artery bypass grafting patient with recurrent angina.

This article has been cited by other articles:

				G. Tavilla, N. H.J. Pijls, K. H. Peels, and E. Berreklouw Noninvasive assessment of coronary flow reserve in the right gastroepiploic artery graft Ann. Thorac. Surg., December 1, 2000; 70(6): 2040 - 2044. [Abstract] [Full Text] [PDF]

				O. M. Shapira, J. D. Alkon, D. S.F. Macron, J. F. Keaney Jr, J. A. Vita, G. S. Aldea, and R. J. Shemin Nitroglycerin is preferable to diltiazem for prevention of coronary bypass conduit spasm Ann. Thorac. Surg., September 1, 2000; 70(3): 883 - 888. [Abstract] [Full Text] [PDF]

				O. M. Shapira, A. Xu, J. A. Vita, G. S. Aldea, N. Shah, R. J. Shemin, and J. F. Keaney Jr NITROGLYCERIN IS SUPERIOR TO DILTIAZEM AS A CORONARY BYPASS CONDUIT VASODILATOR J. Thorac. Cardiovasc. Surg., May 1, 1999; 117(5): 906 - 911. [Abstract] [Full Text] [PDF]

				M. Gaudino, M. Serricchio, P. Tondi, F. Glieca, A. Giordano, C. Trani, P. Pola, and G. Possati Non-invasive evaluation of mammary artery flow reserve and adequacy to increased myocardial oxygen demand Eur. J. Cardiothorac. Surg., April 1, 1999; 13(4): 404 - 409. [Abstract] [Full Text] [PDF]

				M. Gaudino, M. Serricchio, F. Glieca, P. Bruno, P. Tondi, A. Giordano, C. Trani, M. L. Calcagni, P. Pola, and G. Possati Steal phenomenon from mammary side branches: when does it occur? Ann. Thorac. Surg., December 1, 1998; 66(6): 2056 - 2062. [Abstract] [Full Text] [PDF]