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Thorac Cardiovasc Surg 2020; 68(08): 723-729
DOI: 10.1055/s-0040-1714385
Original Cardiovascular

Can the Wall Shear Stress Values of Left Internal Mammary Artery Grafts during the Perioperative Period Reflect the One-Year Patency?

Lan Zhu
1   Department of Radiology, Ruijin Hospital affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
,
Zilai Pan
1   Department of Radiology, Ruijin Hospital affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
,
Zehang Li
2   Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
,
Yunxiao Chang
2   Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
,
Yunpeng Zhu
3   Department of Cardiac Surgery, Ruijin Hospital affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
,
Fuhua Yan
1   Department of Radiology, Ruijin Hospital affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
,
Shengxian Tu
2   Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
,
Wenjie Yang
1   Department of Radiology, Ruijin Hospital affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
› Author Affiliations Funding This study was funded by the National Natural Science Foundation of China (No. 81501467).
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Abstract

Purpose The left internal mammary artery (LIMA) is the preferred graft for coronary artery bypass grafting, but the reasoning for LIMA occlusion is unclear. We sought to examine whether the wall shear stress (WSS) values of LIMA grafts during the perioperative period reflected the 1-year patency by using combining computational fluid dynamics (CFD) and coronary computed tomography angiography (CCTA) images.

Methods CCTA was performed in 233 patients with LIMA graft perioperatively and 1 year later from October 2014 to May 2017. LIMA occlusion was detected in six patients at the 1-year follow-up CCTA. Two patients were excluded due to poor imaging quality. The remaining four patients were enrolled as occlusive (OCC) group, and eight patients with patent LIMA were recruited as patent (PAT) group. The WSS values of LIMA during perioperative period were calculated. LIMA graft was artificially divided into three even segments, proximal (pLIMA), middle (mLIMA) and distal (dLIMA) segments. The independent samples t-test and the Student–Newman–Keuls test were used.

Results The WSS values of dLIMA were significantly higher in the PAT group than in the OCC group (4.43 vs. 2.56, p < 0.05). The WSS values of dLIMA in the PAT group were significantly higher than pLIMA, which was absent in the OCC group.

Conclusions A higher WSS value of the distal segment of LIMA and a higher WSS value of the distal segment compared with the proximal segment of LIMA in the PAT were observed; this tendency might be helpful in predicting the 1-year patency of LIMA.

Keywords

wall shear stress - left internal mammary artery grafts - coronary computed tomography angiography

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


Informed Consent

Written informed consent was waived by the Institutional Review Board.




Publication History

Received: 26 December 2019

Accepted: 04 May 2020

Article published online:
16 September 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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