{"id":21685,"date":"2016-11-14T07:57:09","date_gmt":"2016-11-14T02:27:09","guid":{"rendered":"https:\/\/cardiophile.org\/?p=21685"},"modified":"2016-11-14T07:57:09","modified_gmt":"2016-11-14T02:27:09","slug":"lima-to-lad-coronary-bypass-graft-cabg","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/","title":{"rendered":"LIMA to LAD coronary bypass graft (CABG)"},"content":{"rendered":"<h2><span style=\"color: #008000;\">LIMA to LAD coronary bypass graft (CABG)<\/span><\/h2>\n<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/PxyrI4oF4YA\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-32750\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/11\/LIMA-LAD-1.jpg\" alt=\"LIMA to LAD coronary bypass graft\" width=\"1200\" height=\"1283\" \/><br \/>\nLIMA to LAD coronary bypass graft: LIMA (left internal mammary artery) is to date the most durable conduit for <a href=\"https:\/\/johnsonfrancis.org\/professional\/factors-determining-the-survival-after-coronary-artery-bypass-surgery\/\">coronary artery bypass grafting<\/a>. It has stood the test of time as the best graft for a coronary artery, being a live arterial graft with very little likelihood for atherosclerotic lesions. Here the LIMA graft is imaged in the lateral view. The image has been darkened a bit by post processing to visualize the LIMA and LAD (left anterior descending coronary artery) well. Since it was an injection into the left subclavian artery just near the LIMA ostium, the contrast density was a bit lower than that of a superselective LIMA injection. The sternal wires indicate the post sternotomy status. Distal flow into the LAD is good even after one and a half decades. Retrograde flow from the anastomotic site into the proximal part of LAD is also seen.<\/p>\n<p>There are specialized catheters available for direct cannulation of the left internal mammary artery. But usually either a Tiger catheter (transradial) or a Judkins right coronary catheter are used for non selectively injecting into the left subclavian artery. Compression of the left brachial artery during the injection will reduce the flow to the left upper limb and enhance flow into the LIMA.<\/p>\n<p>In a study of 130 cases, they used 5F LIMA catheter which was initially directed to left subclavian artery and then advanced over a guidewire for superselective LIMA cannulation [1].<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Reference<\/strong><\/span><\/p>\n<ol>\n<li>Feit A, Reddy CV, Cowley C, Ibrahim B, Zisbrod Z. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/1347484\">Internal mammary artery angiography should be a routine component of diagnostic coronary angiography<\/a>. Cathet Cardiovasc Diagn. 1992 Feb;25(2):85-90.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>LIMA to LAD coronary bypass graft (CABG) LIMA to LAD coronary bypass graft: LIMA (left internal mammary artery) is to date the most durable conduit for coronary artery bypass grafting. It has stood the test of time as the best graft for a coronary artery, being a live arterial graft with very little likelihood for [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":32750,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[18,2],"tags":[922,2024,2057,2077,2113,2181,2183,2194,2472,2948,3713],"class_list":["post-21685","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-angiography-and-interventions","category-cardiology","tag-coronary-bypass-graft","tag-lad","tag-lateral-view","tag-left-anterior-descending-coronary-artery","tag-left-internal-mammary-artery","tag-lima-graft","tag-lima-to-lad","tag-live-arterial-graft","tag-most-durable-conduit-for-coronary-artery-bypass-grafting","tag-post-sternotomy-status","tag-sternal-wires"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>LIMA to LAD coronary bypass graft - in lateral view<\/title>\n<meta name=\"description\" content=\"LIMA to LAD coronary bypass graft seen on left subclavian artery injection, in lateral view. Image has been darkened a bit to see LIMA and LAD well.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"LIMA to LAD coronary bypass graft - in lateral view\" \/>\n<meta property=\"og:description\" content=\"LIMA to LAD coronary bypass graft seen on left subclavian artery injection, in lateral view. Image has been darkened a bit to see LIMA and LAD well.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2016-11-14T02:27:09+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/lima-to-lad-coronary-bypass-graft-cabg\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/lima-to-lad-coronary-bypass-graft-cabg\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"LIMA to LAD coronary bypass graft (CABG)\",\"datePublished\":\"2016-11-14T02:27:09+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/lima-to-lad-coronary-bypass-graft-cabg\\\/\"},\"wordCount\":281,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/lima-to-lad-coronary-bypass-graft-cabg\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"keywords\":[\"coronary bypass graft\",\"LAD\",\"lateral view\",\"left anterior descending coronary artery\",\"left internal mammary artery\",\"LIMA graft\",\"LIMA to LAD\",\"live arterial graft\",\"most durable conduit for coronary artery bypass grafting\",\"post sternotomy status\",\"sternal wires\"],\"articleSection\":[\"Angiography and Interventions\",\"Cardiology\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/lima-to-lad-coronary-bypass-graft-cabg\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/lima-to-lad-coronary-bypass-graft-cabg\\\/\",\"name\":\"LIMA to LAD coronary bypass graft - in lateral view\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/lima-to-lad-coronary-bypass-graft-cabg\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/lima-to-lad-coronary-bypass-graft-cabg\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2016-11-14T02:27:09+00:00\",\"description\":\"LIMA to LAD coronary bypass graft seen on left subclavian artery injection, in lateral view. Image has been darkened a bit to see LIMA and LAD well.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/lima-to-lad-coronary-bypass-graft-cabg\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/lima-to-lad-coronary-bypass-graft-cabg\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/lima-to-lad-coronary-bypass-graft-cabg\\\/#primaryimage\",\"url\":\"\",\"contentUrl\":\"\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/lima-to-lad-coronary-bypass-graft-cabg\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"LIMA to LAD coronary bypass graft (CABG)\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\",\"name\":\"All About Cardiovascular System and Disorders\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\",\"name\":\"Johnson Francis\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"caption\":\"Johnson Francis\"},\"logo\":{\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\"},\"description\":\"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/author\\\/jf\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"LIMA to LAD coronary bypass graft - in lateral view","description":"LIMA to LAD coronary bypass graft seen on left subclavian artery injection, in lateral view. Image has been darkened a bit to see LIMA and LAD well.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/","og_locale":"en_US","og_type":"article","og_title":"LIMA to LAD coronary bypass graft - in lateral view","og_description":"LIMA to LAD coronary bypass graft seen on left subclavian artery injection, in lateral view. Image has been darkened a bit to see LIMA and LAD well.","og_url":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/","og_site_name":"All About Cardiovascular System and Disorders","article_published_time":"2016-11-14T02:27:09+00:00","author":"Johnson Francis","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Johnson Francis","Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/#article","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/"},"author":{"name":"Johnson Francis","@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"headline":"LIMA to LAD coronary bypass graft (CABG)","datePublished":"2016-11-14T02:27:09+00:00","mainEntityOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/"},"wordCount":281,"publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/#primaryimage"},"thumbnailUrl":"","keywords":["coronary bypass graft","LAD","lateral view","left anterior descending coronary artery","left internal mammary artery","LIMA graft","LIMA to LAD","live arterial graft","most durable conduit for coronary artery bypass grafting","post sternotomy status","sternal wires"],"articleSection":["Angiography and Interventions","Cardiology"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/","url":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/","name":"LIMA to LAD coronary bypass graft - in lateral view","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#website"},"primaryImageOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/#primaryimage"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/#primaryimage"},"thumbnailUrl":"","datePublished":"2016-11-14T02:27:09+00:00","description":"LIMA to LAD coronary bypass graft seen on left subclavian artery injection, in lateral view. Image has been darkened a bit to see LIMA and LAD well.","breadcrumb":{"@id":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/#primaryimage","url":"","contentUrl":""},{"@type":"BreadcrumbList","@id":"https:\/\/johnsonfrancis.org\/professional\/lima-to-lad-coronary-bypass-graft-cabg\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/johnsonfrancis.org\/professional\/"},{"@type":"ListItem","position":2,"name":"LIMA to LAD coronary bypass graft (CABG)"}]},{"@type":"WebSite","@id":"https:\/\/johnsonfrancis.org\/professional\/#website","url":"https:\/\/johnsonfrancis.org\/professional\/","name":"All About Cardiovascular System and Disorders","description":"","publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/johnsonfrancis.org\/professional\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec","name":"Johnson Francis","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","caption":"Johnson Francis"},"logo":{"@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g"},"description":"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal","url":"https:\/\/johnsonfrancis.org\/professional\/author\/jf\/"}]}},"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/21685","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/comments?post=21685"}],"version-history":[{"count":0,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/21685\/revisions"}],"wp:attachment":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/media?parent=21685"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/categories?post=21685"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/tags?post=21685"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}