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 language | English (US) |
|---|---|
| Pages (from-to) | 993-997 |
| Number of pages | 5 |
| Journal | Interactive Cardiovascular and Thoracic Surgery |
| Volume | 12 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 2011 |
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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 journal › Article
}
TY - JOUR
T1 - The impact of competitive flow on distal coronary flow and on graft flow during coronary artery bypass surgery
AU - Karapanosa, Nikolaos Tsirikos
AU - Suddendorfa, Scott H.
AU - Li, Zhuo
AU - Huebner, Marianne
AU - Joyce, Lyle D.
AU - Park, Soon J.
PY - 2011/6
Y1 - 2011/6
N2 - 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.
AB - 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.
KW - Competitive flow
KW - Coronary artery bypass graft
KW - Left anterior descending
KW - Left internal mammary artery
UR - http://www.scopus.com/inward/record.url?scp=79958733306&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79958733306&partnerID=8YFLogxK
U2 - 10.1510/icvts.2010.255398
DO - 10.1510/icvts.2010.255398
M3 - Article
VL - 12
SP - 993
EP - 997
JO - Interactive Cardiovascular and Thoracic Surgery
JF - Interactive Cardiovascular and Thoracic Surgery
SN - 1569-9293
IS - 6
ER -