Unligated side branches of the left internal mammary artery (LIMA) have been indicated as a cause of coronary steal resulting in postoperative angina. Although a number of studies have reported successful embolization of the side branches to relieve angina, this phenomenon is still controversial and it has been either emphasized or rejected in studies that attempted to obtain hemodynamic evidence of the steal using angiographic and intravascular Doppler techniques. In this case study, we tried to reproduce physiological decrease in the muscular and coronary beds as it could occur during activity. Our results, using an intracoronary Doppler wire with adenosine combined with forced ventilation, showed that a trial occlusion of the LIMA side branch with a balloon technique can demonstrate whether the flow through the LIMA would increase after embolization of the side branch.

译文

:左乳内动脉未结扎的侧支(LIMA)已被表明是导致术后心绞痛的冠状动脉盗窃的原因。尽管许多研究报告称成功完成了侧支栓塞以缓解心绞痛,但该现象仍存在争议,在尝试使用血管造影和血管内多普勒技术获得血流动力学证据的研究中,这种现象一直被强调或拒绝。在本案例研究中,我们尝试重现肌肉和冠状动脉床层的生理下降,因为这种下降可能在活动期间发生。我们的研究结果通过使用冠状动脉内多普勒导线和腺苷联合强制通气,表明通过气球技术对LIMA侧支进行的试验性闭塞可以证明在栓塞后,通过LIMA的血流是否会增加。

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