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This syndrome of "coronary theft", which affects the arterial flow from the left internal thoracic artery to the interventricular branch of the left coronary artery, has been widely documented and attributed to the presence of a larger collateral branch (Wolfenden & Newman, 1992; Nakhjavan et al.; Sbarouni et al., 1994; Chavan et al., 1996), the lateral costal branch being one of them (Sbarouni et al.; Hijazi et al., 1996; Guzon et al., 2004; Abdo et al., 2005; Nishi et al., 2012).
Harvesting the saphenous vein with surrounding tissue for CABG provides long-term graft patency comparable to the left internal thoracic artery: Results of a randomized longitudinal trial.
She had undergone an uncomplicated 2-vessel coronary artery bypass grafting (CABG) 2 months prior, with grafts to the left anterior descending artery using the left internal thoracic artery and to the right coronary artery from the aorta using saphenous vein.
In this case a large lowest thyroid artery took origin from the left internal thoracic artery to supply the thyroid gland.
The patient underwent myocardial revascularization and anastomosis of the left internal thoracic artery to the left anterior descending artery was performed on the beating heart via median sternotomy.
The use of left internal thoracic artery (LITA) as a bypass conduit is associated with the highest long term patency rate and greater life expectancy with respect to saphenous vein (SV) and radial artery grafts after coronary artery bypass grafting (CABG) (1).
Use of bilateral internal thoracic artery (BITA) grafts is associated with improved long-term survival (1), reduced incidence of recurrent angina, and decreased cardiac events compared with patients receiving only left internal thoracic artery (LITA) graft (2, 3).
The main strategy of coronary artery bypass grafting (CABG) is based on grafting the left internal thoracic artery (LITA) to left anterior descending artery (LAD) and using the saphenous vein graft (SVG) for the remaining affected vessels and anastomosing the grafts proximally to the ascending aorta.