Document Detail


Do changes in blood flow in the subclavian artery affect flow volume in IMA grafts after complete arterial revascularization with the T-graft technique?
MedLine Citation:
PMID:  11339457     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The T-graft procedure achieves complete arterial coronary revascularization with only two conduits. In this technique, all the bypass anastomoses are supplied by the left internal mammary artery (IMA). Changes in flow conditions or flow redistribution in the subclavian artery may thus sigificantly influence coronary perfusion. The objective of this study was to determine whether changes in blood flow in the subclavian artery affect the flow in IMA grafts in patients who have undergone complete arterial revascularization with T-grafts. METHODS: Quantitative flow volume and flow profiles in the IMA graft and the proximal subclavian artery were measured with a flow-wire in 20 patients one week postoperatively. Following baseline measurements, brachial artery constriction was achieved by applying a blood pressure measurement cuff to the patient's left upper arm. After 5 minutes, quantitative flow in the IMA and in the proximal subclavian artery was assessed. The cuff was then released and the measurements repeated. RESULTS: Flow in the subclavian artery changed significantly (p < 0.01) from baseline (355.4 +/- 95.2 ml/ min) to constriction (171.2 +/- 61.3 ml/min) and hyperemia (679.3 +/- 195.1 ml/min). Flow in the IMA graft remained constant irrespective of subclavian artery flow (75.4 +/- 26.2 ml/min vs. 78.0 +/- 28.9 ml/min vs. 75.5 +/- 29.3 ml/min, respectively). The flow profile in the IMA was similarily unchanged. CONCLUSION: In patients in whom the coronary bypass blood flow is dependent on the left IMA, neither the quantitative flow volume nor the flow profile are altered by changes in blood flow of the subclavian artery.
Authors:
B Hennen; T Markwirth; B Scheller; H J Schäfers; O Wendler
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  49     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-05-07     Completed Date:  2001-09-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  84-8     Citation Subset:  IM    
Affiliation:
Medizinische Klinik III (Kardiologie/Angiologie), Universitätskliniken des Saarlandes, Homburg/Saar, Germany. hennen@med-in.uni-sb.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Flow Velocity
Coronary Angiography
Coronary Artery Bypass / adverse effects,  methods*
Coronary Disease / diagnosis,  physiopathology,  surgery*
Female
Follow-Up Studies
Graft Survival
Heart Catheterization
Humans
Laser-Doppler Flowmetry
Male
Mammary Arteries / transplantation*
Middle Aged
Postoperative Period
Probability
Prospective Studies
Subclavian Artery / physiopathology*,  ultrasonography*
Treatment Outcome

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


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