Document Detail

Competitive flow from a fully patent coronary artery does not limit acute mammary graft flow.
MedLine Citation:
PMID:  1351715     Owner:  NLM     Status:  MEDLINE    
The shriveled, stenotic mammary graft sometimes observed after internal mammary artery (IMA) to coronary artery bypass grafting has been attributed to competitive flow from the insufficiently stenosed native coronary vessel. To study further the effects of native coronary artery competing flow on IMA graft flow, 10 dogs (mean weight, 23.5 +/- 3.69 kg) underwent coronary artery bypass grafting using the pedicled left IMA anastomosed to a normal, fully patent proximal circumflex (CFX) coronary artery. The procedure was performed through a left thoracotomy, off pump, using a brief local occlusion to perform the anastomosis. Native in situ IMA flow, CFX flow distal to the anastomosis, and IMA graft flow were measured using calibrated electromagnetic flow probes. When the CFX proximal to the anastomosis was occluded transiently, IMA flow increased to supply 100% of the previously measured distal CFX flow (60.2 +/- 7.9 mL/min). When both the IMA graft and CFX proximal to the anastomosis were patent, total distal perfusion was maintained (58.9 +/- 7.8 mL/min) and relative IMA graft flow (26.5 +/- 3.3 mL/min) was proportional to the relative diameter of the IMA graft to the native coronary artery (r = 0.96). The mean flow in the IMA in situ on the chest wall before its division was 23.8 +/- 8.1 mL/min. These results suggest that, at least acutely in a canine model, IMA graft flow is maintained above in situ levels even when grafted to a completely patent coronary artery and that acute competitive flow probably does not cause mammary artery shriveling.
P A Spence; R M Lust; R S Zeri; S R Jolly; P M Mehta; M Otaki; Y S Sun; W R Chitwood
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  54     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1992 Jul 
Date Detail:
Created Date:  1992-07-21     Completed Date:  1992-07-21     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  21-5; discussion 25-6     Citation Subset:  AIM; IM    
Division of Cardiothoracic Surgery, East Carolina University School of Medicine, Greenville, North Carolina 27858.
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MeSH Terms
Coronary Circulation / physiology*
Coronary Vessels / anatomy & histology,  physiology*
Internal Mammary-Coronary Artery Anastomosis
Mammary Arteries / anatomy & histology,  physiology*
Myocardial Revascularization*
Vascular Patency / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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