Document Detail

Immediate flow reserve of Y thoracic artery grafts: an intraoperative flowmetric study.
MedLine Citation:
PMID:  14566250     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Use of both internal thoracic arteries in a Y graft configuration can raise concerns about the possibility of the single left internal thoracic artery being able to meet the flow requirements of two or three distal territories. We evaluated intraoperatively the flow reserve of a Y thoracic artery graft distally anastomosed to the anterior and lateral territories. METHODS: In 21 patients who had Y thoracic artery grafts, the flow was measured in the main stem of the left internal thoracic artery, in the left internal thoracic artery branch, and in the right internal thoracic artery. A transit time Doppler flowmeter was used. Measurements were repeated after the injection of a bolus of 20 mug/kg dobutamine. RESULTS: At baseline condition, the mean blood flow was 44.8 +/- 24.2, 23.4 +/- 11.5, and 21.4 +/- 15.3 mL/min in the main stem of the left internal thoracic artery, in the left internal thoracic artery branch, and in the right internal thoracic artery, respectively. After dobutamine injection, these values increased to 93.2 +/- 49.8, 46.1 +/- 22.6, and 42.5 +/- 31.2 mL/min, respectively. Flow reserve was 2.1 +/- 0.6, 2.2 +/- 0.9, and 2.1 +/- 0.9 mL/min, respectively. CONCLUSIONS: Intraoperative injection of dobutamine increases the flow in the Y thoracic graft by more than two times, not only in the main stem but also in each branch. This finding attests to the safety of Y thoracic conduits in terms of hemodynamic potential.
Mario Gaudino; Michele Di Mauro; Angela Lorena Iacò; Carlo Canosa; Giuseppe Vitolla; Antonio Maria Calafiore
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  126     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-20     Completed Date:  2003-12-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1076-9     Citation Subset:  AIM; IM    
Department of Cardiology and Cardiac Surgery, G. D'Annunzio University, Chieti, Italy.
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MeSH Terms
Coronary Circulation / physiology
Dobutamine / diagnostic use
Intraoperative Period
Mammary Arteries / physiology*
Middle Aged
Myocardial Revascularization*
Reg. No./Substance:

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