Document Detail


Flow measurements through aortocoronary and intraluminal coronary shunts.
MedLine Citation:
PMID:  10546522     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Temporary insertion of shunts during coronary artery bypass grafting (CABG) on the beating heart may provide the minimal flow required for adequate myocardial protection (40 to 60 ml/min). We investigated the flow as a function of the pressure head over three aortocoronary shunts and one intraluminal coronary shunt. METHODS: The aortocoronary shunts (VS-01590 with bulb size 2, 3 and 4 mm) and the intraluminal shunt (IVS-4030, bulb size 4 mm) were perfused with 47% glycerin solution at 37 degrees C. The preload was raised in 5 mmHg steps from 35 to 80 mmHg. The afterload was set at 12 mmHg. A regression analysis of the flow on the pressure head was performed. RESULTS: For maximal preload the flow through the aortocoronary shunts was 15.9 +/- 1.3, 46.2 +/- 2.2 and 75.4 +/- 3.3 ml/min, for the intraluminal shunt it was 76.1 +/- 3.4 ml/min. To provide a flow of 40 ml/min a preload of 70, 50 and 45 mmHg was necessary for the 3 mm and 4 mm aortocoronary shunt and the intraluminal shunt respectively. For the aortocoronary and the intraluminal shunts the beta-coefficients were 0.27, 0.66, 1.13 and 1.02 ml/(min*mmHg) respectively with all p < 0.0001. CONCLUSIONS: For adequate pressure head the 3 mm and 4 mm aortocoronary shunt and the intraluminal shunt provide myocardial protection. In case of severe proximal coronary stenosis the intraluminal shunt will not guarantee myocardial protection and main benefit reduces to working in a bloodless field. The insertion of shunts is a cheap and simple method to optimize CABG on the beating heart.
Authors:
C Jaggy; M Lachat; B Leskosek; M Kunz; G Zünd; M Turina
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera     Volume:  5     ISSN:  1023-9332     ISO Abbreviation:  Swiss Surg     Publication Date:  1999  
Date Detail:
Created Date:  1999-11-18     Completed Date:  1999-11-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9514313     Medline TA:  Swiss Surg     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  228-32     Citation Subset:  IM    
Affiliation:
Clinic for Cardiovascular Surgery, University Hospital Zurich.
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MeSH Terms
Descriptor/Qualifier:
Arteriovenous Shunt, Surgical*
Blood Flow Velocity*
Coronary Artery Bypass*
Female
Humans
Male
Myocardial Ischemia / surgery
Myocardial Revascularization

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


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