Functional evaluation of revascularization of the descending anterior coronary artery with the left internal mammary artery by studying the coronary reserve with transthoracic echocardiography

Transthoracic echocardiography allows the coronary flow reserve to be determined non-invasively, and is a useful method to evaluate the functional results of coronary circulation after revascularization. The aim of this study was to analyse the different factors that affect the coronary flow reserve after revascularization of the descending anterior coronary artery with the left internal mammary artery. Material and methods: The coronary flow reserve was studied three months after surgery using transthoracic echocardiography. The study included 43 patients with no clinical signs of ischemia in the anterior wall after coronary artery bypass graft surgery with left internal mammary artery. A control group of 50 cases with similar cardiovascular risks, but without ischemic cardiomyopathy was also studied. Results: Although both groups showed low coronary flow reserve, patients that underwent surgery had a lower result (2.00 (SD 0.52)) than control patients with cardiovascular risk factors (2.93 (SD 0,80)), P < .001. A multivariate analysis showed that coronary flow reserve is lower when severity of the lesion is smaller 2.66E-02 (0.003-0.05), P = .028 and also when the quality of the distal vessel is worse 0.361 (0.070-0.651), P = .016.