caa a22 4500 397496788 CHVBK 20180308164523.0 cr unu---uuuuu 161202e199504 xx s 000 0 eng 10.1016/S1010-7940(05)80143-5 doi (NATIONALLICENCE)oxford-10.1016/S1010-7940(05)80143-5 The internal mammary artery malperfusion syndrome: incidence, treatment and angiographic verification [Elektronische Daten] Internal mammary artery (IMA) malperfusion syndrome is caused by anacute imbalance between myocardial demand and nutritional support throughthe mammary artery. In a consecutive series of 2326 isolated myocardialrevascularizations-with at least one IMA to the left anterior descendingbranch (LAD) in 91.3% (2125/2326)-we identified 45 patients (1.9%) with aperioperative course suggesting IMA malperfusion syndrome. Additionalsaphenous vein graft to the distal segment of the LAD was performed duringnormothermic ventricular fibrillation in all patients. Hospital mortalitywas 4.4% (2/45), intra-aortic balloon pumping was required in 15.5% (7/45)and anterior myocardial infarction occurred in 28.8% (13/45). Coronaryangiography was performed in all survivors between 3 and 24 monthspostoperatively. Wide patent IMA graft and patent saphenous vein graft wereobserved in 56% (24/43), narrowed but patent IMA graft and patent veingraft in 35% (15/43), while patent vein graft and not visualized IMA in 7%(3/43); in one patient with severely diseased peripheral LAD, no flow couldbe demonstrated in the IMA graft or in the additional vein graft (1/43,2.4%). No major differences were found between early and late coronaryangiography in these patients. Additional vein graft to distal LAD is thetreatment of choice in acute IMA malperfusion syndrome. Despite patent veingraft with superior blood flow, early and late postoperative IMA flow toLAD is maintained in the majority of patients. © Springer-Verlag 1995 European Journal of Cardio-Thoracic Surgery Elsevier Science B.V. 9/4(1995-04), 190-195 1010-7940 9:4<190 1995 9 ejcts https://doi.org/10.1016/S1010-7940(05)80143-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1016/S1010-7940(05)80143-5 text/html Onlinezugriff via DOI NATIONALLICENCE 773 0- European Journal of Cardio-Thoracic Surgery Elsevier Science B.V 9/4(1995-04), 190-195 1010-7940 9:4<190 1995 9 ejcts Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford