The impact of competitive flow on distal coronary flow and on graft flow during coronary artery bypass surgery

Nikolaos Tsirikos Karapanosa, Scott H. Suddendorfa, Zhuo Li, Marianne Huebner, Lyle D. Joyce, Soon J. Park

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

To determine the impact of left anterior descending-competitive flow (LAD-CF) on distal coronary flow (LAD-DF) and on left internal mammary artery-graft flow (LIMA-GF), we performed a quantitative blood-flow analysis in a swine model of a LIMA-to-LAD coronary artery bypass graft (CABG). In six swine, a LIMA-to-LAD CABG was performed. LAD blood-flow was measured bilaterally to the LIMA-to-LAD anastomosis, in the LIMA and in the pulmonary artery (cardiac output, CO) along with the LIMA pulsatility index (LIMA-PI) and the left ventricular pressure (LVP). PreCABG measurements were followed by postCABG measurements at five levels of LAD-CF: 100%, 75%, 50%, 25% and 0% after gradually snaring down a snare placed proximally of the LAD-CF flow-probe. PreCABG CO and LVP remained unchanged postCABG. LAD-DF was reduced significantly postCABG (-33%, P<0.0001). Reduction of the LAD-CF (at 75%, 50%, 25% and 0%) resulted in significant increase of LIMA-GF (q38%, q63%, q113%, q225%, P<0.036 at all LAD-CF levels), reduced PI (6.8, 5.7, 4.1, 3.1, 2.5) with simultaneous increase of LAD-DF (q8%, PsNS, q8%, PsNS, q17%, PsNS, q50%, Ps0.0044). Decreased LAD-CF resulted in increased LADDF, increased LIMA-GF and decreased LIMA-PI. To the best of our knowledge, this is the first study where blood-flow was directly and simultaneously measured in all the components of the LIMA-to-LAD anastomosis.

Original languageEnglish (US)
Pages (from-to)993-997
Number of pages5
JournalInteractive Cardiovascular and Thoracic Surgery
Volume12
Issue number6
DOIs
StatePublished - Jun 2011

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Coronary Artery Bypass
Mammary Arteries
Transplants
Ventricular Pressure
Cardiac Output
Swine
Pulmonary Artery

Keywords

  • Competitive flow
  • Coronary artery bypass graft
  • Left anterior descending
  • Left internal mammary artery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

The impact of competitive flow on distal coronary flow and on graft flow during coronary artery bypass surgery. / Karapanosa, Nikolaos Tsirikos; Suddendorfa, Scott H.; Li, Zhuo; Huebner, Marianne; Joyce, Lyle D.; Park, Soon J.

In: Interactive Cardiovascular and Thoracic Surgery, Vol. 12, No. 6, 06.2011, p. 993-997.

Research output: Contribution to journalArticle

Karapanosa, Nikolaos Tsirikos ; Suddendorfa, Scott H. ; Li, Zhuo ; Huebner, Marianne ; Joyce, Lyle D. ; Park, Soon J. / The impact of competitive flow on distal coronary flow and on graft flow during coronary artery bypass surgery. In: Interactive Cardiovascular and Thoracic Surgery. 2011 ; Vol. 12, No. 6. pp. 993-997.
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