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Ann Thorac Surg. 2000 Oct;70(4):1338-44.

Histology and morphology of 59 internal thoracic artery grafts and their distal anastomoses.

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  • 1Institute of Biomedical Engineering, University of Toronto and the Department of Pathology, The Toronto General Hospital, Ontario, Canada.

Abstract

BACKGROUND:

The left internal thoracic artery (LITA) is accepted as a superior graft for the left coronary system because of its better long-term patency rate than saphenous grafts. The postsurgical histomorphometric changes at the distal anastomosis of LITA grafts are not well documented.

METHODS:

The cellular changes within the intima of 59 LITA grafts were analyzed by light microscopy.

RESULTS:

Grafts implanted 1 week or less (n = 34) showed no postsurgical tissue proliferation. Of the 7 grafts implanted 1 to 8 weeks, only the suture sites exhibited intimal thickening (6 of 7 grafts, 0.08 +/- 0.07 mm). The remaining grafts (n = 18), aged 2 months to 10 years, showed significant intimal thickening at the suture sites (0.39 +/- 0.17 mm) and on the hood (0.29 +/- 0.25 mm), with variable thickening on the floor (10 of 18 left anterior descending coronary arteries, 0.11 +/- 0.12 mm). The graft body showed insignificant intimal changes (10 of 18, 0.03 +/- 0.04 mm), with mild focal atherosclerotic lesions in 2 of 18 late LITA grafts.

CONCLUSIONS:

Left internal thoracic artery grafts develop fibromuscular intimal hyperplasia primarily around the anastomosis. The response on the hood appears to be a hemodynamic response, secondary to that of the suture sites.

PMID:
11081895
[PubMed - indexed for MEDLINE]
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