Document Detail


Flow study of surgical coronary artery fistula as an alternative to sequential bypass.
MedLine Citation:
PMID:  7582990     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Surgical coronary artery fistula, in which the last anastomosis is created to a low-pressure cardiac chamber, was recently introduced as an alternative method to improve graft flow and patency in a sequential graft when coronary arteries are small or diffusely diseased. To assess graft flow, effect on haemodynamics, flow distribution and to determine proper size of the distal anastomosis, a saphenous vein was sequentially anastomosed from the ascending aorta to the left anterior descending artery and then to the left atrium in eight mongrel dogs. Graft flow was measured before and after opening the fistula to the left atrium between the ascending aorta and left anterior descending artery (flow A) and between the left anterior descending artery and left atrium (flow B). Left atrium pressure and systolic left ventricular pressure (mmHg) were recorded. The diameter of the distal anastomosis was regulated with a bulldog clamp. When distal anastomosis was at 2.5-3 mm mean(s.d.) flow A increased from 64.5(19.5) to 134.7(28.5) ml/min (P < 0.01) without significant left atrial pressure or left ventricular pressure change. With a distal anastomosis of 4 mm or more, flow A increased from 69.8(19.9) to 396.1(62.2) ml/min (P < 0.001). Left atrial pressure increased from 5.6(1.0) to 6.1(0.9) mmHg (P < 0.05) without a change in left ventricular pressure. In both sizes of distal anastomosis, flow to the left anterior descending artery did not change either before or after the shunt (flow B) was opened. Neither volume loading, rapid atrial pacing, neosynephrine or epinephrine infusions caused deleterious haemodynamic effects with the shunt open.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
H Nishida; M Endo; H Koyanagi; R K Grooters; D F Merkley
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cardiovascular surgery (London, England)     Volume:  3     ISSN:  0967-2109     ISO Abbreviation:  Cardiovasc Surg     Publication Date:  1995 Aug 
Date Detail:
Created Date:  1995-12-06     Completed Date:  1995-12-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9308765     Medline TA:  Cardiovasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  375-80     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College.
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical / methods*
Animals
Blood Flow Velocity / physiology
Blood Volume / physiology
Cardiac Pacing, Artificial
Coronary Artery Bypass / methods*
Coronary Circulation / physiology*
Coronary Disease / physiopathology,  surgery*
Dogs
Graft Occlusion, Vascular / physiopathology*
Heart Atria / surgery
Hemodynamics / physiology
Saphenous Vein / transplantation

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


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