Abstract
An unusual case of left internal thoracic artery (ITA) origin from the thyrocervical trunk (TCT) was detected during routine cadaver dissection. The variability of origin and course of ITA has less or more frequently been documented in the literature. However, the ITA origin from the TCT on the left side has been detected less commonly, making its dissection and preparation during coronary artery bypass grafting surgery more difficult. We discuss the ITA origin and course variability as well as clinical significance of the present variant, reviewing the relative literature. The objective of our study is to exhibit a rare ITA origin in order to provide a more accurate knowledge of such variations.
Highlights
Internal thoracic artery (ITA) is a trait of important anatomical variability and clinical significance. It is widely utilized for coronary artery bypass grafting (CABG) surgery
The ITA’s anatomic characteristics, such as distinct intrathoracic course and anatomical vicinity with the heart [1], its long-term patency [1,2,3,4], the long-term survival rate [2,4] and post-operative quality of life [5] render it as an excellent arterial graft for myocardial revascularization
Based on our review of the literature and the frequency of the anatomical variation studied, we suggest preoperative selective angiographic evaluation involving the subclavian artery (SCA)-ITA junction, except from the cases in which serious contraindications are present
Summary
Internal thoracic artery (ITA) is a trait of important anatomical variability and clinical significance. It is widely utilized for coronary artery bypass grafting (CABG) surgery. Anomalous origin of the ITA has continually been reported in the literature. Unilateral [4,6,7] or bilateral [8] ITA origin from the lateral part of the subclavian artery (SCA) has been mentioned in less than 1 % of the studied cases [6], while the possible common origin of the ITA and branches of the thyrocervical trunk (TCT) is clinically underestimated in general. Does the ITA common origin from the TCT affect the implant’s suitability and survival? The variability in ITA origin gives birth to intense interest and extensive research in order to avoid surgical complications and clinical discomfort. We study the anatomic relationship of common ITA
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