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Eur J Cardiothorac Surg 2001;20:1135-1141
© 2001 Elsevier Science NL

Differences in LIMA Doppler characteristics for different LAD perfusion areas

^a Department of Cardiothoracic Surgery, University Hospital Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
^b Department of Cardiology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands
^c Department of Clinical Neurophysiology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands
^d Department of Thoracic and Cardiovascular Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands

Received 10 October 2000; received in revised form 1 June 2001; accepted 14 September 2001.

Corresponding author. Tel.: +31-10-4635411; fax: +31-10-4633993
e-mail: jmhartman88{at}hotmail.com

Objectives: To correlate supraclavicular left internal mammary artery (LIMA) to left anterior descending artery (LAD) area Doppler characteristics with angiographically perfused area. Methods: Sixty patients (50 male, mean age 62±7.3 years) with LIMA to LAD area grafting were prospectively entered in a follow up study. Supraclavicular echo Doppler of the LIMA was studied at the LIMA origin preoperatively, and at 4.8±3.8 months and 1.8±0.9 years postoperatively. The potential area to be revascularized judged from preoperative angiography was called the ‘target’ area. Control angiography (native and LIMA) was done at 1.5±0.9 years. The perfused area % was classified into group I 17.0% (n=16), group II >17.0% and <22.50% (n=17), and group III 22.50% (n=18) and related to LIMA Doppler characteristics. Multivariate linear regression analyses (MLRA) were performed to assess the relations between Doppler variables and the perfused area, target area and ratio of perfused/target area. Results: At MLRA perfused area was significantly related to the natural logarithm of diastolic peak velocity (DPV) (P=0.013) and diastolic mean velocity (P=0.048) and the ratio only to the degree of LAD stenosis (P=0.004). In hyperaemic response maximal DPV (DPV max) showed significant correlation to the perfused area (P=0.005) as well as to the ratio (P=0.017). When analyzing the additive power of both investigations, only DPV max (P=0.005) correlated significantly to the perfused area and for the ratio only the degree of stenosis of the LAD emerged as significant (P=0.004). Conclusions: At MLRA the diastolic flow pattern at rest and the maximal DPV in hyperaemic response correlated significantly with the LIMA run-off area whereas the last variable is the strongest predictor of the LIMA run-off area.

Key Words: Left internal mammary artery • Doppler characteristics • Left anterior descending artery

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