Patency of an internal thoracic artery graft despite maximal competitive flow

Recent evidence has suggested that competitive flow is an important factor in early graft failure. In this case report an internal thoracic artery graft was used to revascularize an acute coronary artery dissection after balloon angioplasty. Subsequent angiography 4 months later showed complete healing of the dissection, yet the internal thoracic artery graft remained widely patent in spite of the maximal competitive flow from the native coronary artery. This concurs with experimental results recently reported in The Annals regarding the physiologic adapability of the internal thoracic artery graft to suit flow requirements and its versatility as the conduit of choice.