Is internal thoracic artery grafting suitable for a moderately stenotic coronary artery?
Grafting an internal thoracic artery to a coronary artery with moderate stenosis remains controversial. Competitive flow from the native coronary artery has been proposed as the cause of distal narrowing and ultimate failure of the internal thoracic artery graft. We investigated intraoperative phasic blood flow in internal thoracic arteries grafted to coronary arteries with various degrees of stenosis and the influence of stenosis on postoperative angiographic findings. One hundred patients who underwent coronary artery bypass grafting of an internal thoracic artery to the left anterior descending coronary artery were divided into three groups according to degree of coronary stenosis. Group 1 included 39 patients who had 75% or less stenosis, group 2 included 34 patients with stenosis from 76% to 90%, and group 3 included 27 patients with stenosis greater than 90%. Mean flow and peak systolic flow of internal thoracic artery graft in group 1 were lower than those in group 2 (p < 0.01,
