| Steal phenomenon from mammary side branches: when does it occur? | |
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MedLine Citation:
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PMID: 9930493 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The hemodynamic significance of patent mammary graft side branches is still controversial. This study was designed to evaluate the potential for flow steal of patent mammary side branches in different hemodynamic conditions. METHODS: Echo-Doppler measurement of mammary graft flow was performed at rest and after dipyridamole-induced coronary vasodilatation in 10 patients with angiographic demonstration of evident mammary graft side branches (study group) and in 10 matched control patients (control group). Concomitant thallium-201 myocardial scintigraphy was performed to assess the adequacy of mammary flow to the myocardial oxygen demand. Patients of the study group were also submitted to flow evaluation in condition of selective muscular or combined systemic and coronary relaxation. RESULTS: No difference in mammary flow and adequacy to myocardial oxygen demand was detected between patients of the study and control groups both at rest and after dipyridamole infusion. In patients with patent side branches the systolic-to-diastolic flow ratio was maintained in case of combined coronary and peripheral vasodilatation, whereas selective muscular relaxation led to an increase in the systolic and a reduction in the diastolic flow. CONCLUSIONS: Flow steal from patent mammary graft side branches is possible only in case of selective muscular vasodilatation. As this situation is unlikely to occur in the clinical setting, the potential for flow steal of mammary side branches in cardiac surgery patients seems to be minimal. |
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Authors:
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M Gaudino; M Serricchio; F Glieca; P Bruno; P Tondi; A Giordano; C Trani; M L Calcagni; P Pola; G Possati |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 66 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 1998 Dec |
Date Detail:
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Created Date: 1999-02-18 Completed Date: 1999-02-18 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 2056-62 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiac Surgery, Catholic University, Rome, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Case-Control Studies Coronary Angiography Coronary Circulation / physiology Dipyridamole / diagnostic use Echocardiography, Doppler Heart / radionuclide imaging Humans Internal Mammary-Coronary Artery Anastomosis* Mammary Arteries / anatomy & histology, physiopathology* Nifedipine / diagnostic use Postoperative Complications / etiology, physiopathology* Vasodilator Agents / diagnostic use |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 21829-25-4/Nifedipine; 58-32-2/Dipyridamole |
| Comments/Corrections | |
Comment In:
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Ann Thorac Surg. 1998 Dec;66(6):1873-5
[PMID:
9930462
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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