Intraoperative Doppler velocity measurements to locate patent ITA grafts at reoperation.

We are reporting a case of a patient who underwent an aortic valve replacement with previous coronary artery bypass grafting. During the operation we used a Doppler velocity probe to locate the exact position of the bilateral internal thoracic arteries. Once the vessels were identified, a suture was passed widely around each internal thoracic artery and a snare was positioned. With the aid of the Doppler velocity probe, we achieved a gentle occlusion of the vessels, applying enough traction on the snares to abolish the flow through the internal thoracic arteries.