Transthoracic Doppler echocardiography of the left internal mammary artery graft.

Assessment of the left internal mammary artery (LIMA) graft patency currently requires invasive investigation through coronary angiography. In the last years the successful application of noninvasive Doppler spectrum analysis has been reported for patency assessment of the LIMA graft after myocardial revascularization. Echocardiography is considered to be a sensitive noninvasive screening modality to diagnose critical narrowing of LIMA grafts and angiography should be reserved for cases in which Doppler echocardiography fails to visualize the LIMA or reveals an abnormal flow pattern.