Thorac Cardiovasc Surg 2001; 49(2): 84-88
DOI: 10.1055/s-2001-11701
Original Cardiovascular
Original Original Cardiovascular
© Georg Thieme Verlag Stuttgart · New York

Do Changes in Blood Flow in the Subclavian Artery Affect Flow Volume in IMA Grafts After Complete Arterial Revascularization with the T-Graft Technique?[*]

B. Hennen1 , T. Markwirth1 , B. Scheller1 , H.-J. Schäfers2 , O. Wendler2
  • 1Medizinische Klinik III (Kardiologie/Angiologie), Universitätskliniken des Saarlandes, Homburg/Saar, Germany
  • 2Abteilung für Thorax- und Herz-Gefässchirugie, Universitätskliniken des Saarlandes, Homburg/Saar, Germany
Further Information

Publication History

Publication Date:
31 December 2001 (online)

Background: The T-graft procedure achieves complete arterial coronary revascularization with only two conduits. In this technique, all the bypass anastomoses are supplied by the left internal mammary artery (IMA). Changes in flow conditions or flow redistribution in the subclavian artery may thus sigificantly influence coronary perfusion. The objective of this study was to determine whether changes in blood flow in the subclavian artery affect the flow in IMA grafts in patients who have undergone complete arterial revascularization with T-grafts. Methods: Quantitative flow volume and flow profiles in the IMA graft and the proximal subclavian artery were measured with a flow-wire in 20 patients one week postoperatively. Following baseline measurements, brachial artery constriction was achieved by applying a blood pressure measurement cuff to the patient's left upper arm. After 5 minutes, quantitative flow in the IMA and in the proximal subclavian artery was assessed. The cuff was then released and the measurements repeated. Results: Flow in the subclavian artery changed significantly (p < 0.01) from baseline (355.4 ± 95.2 ml/min) to constriction (171.2 ± 61.3 ml/min) and hyperemia (679.3 ± 195.1 ml/min). Flow in the IMA graft remained constant irrespective of subclavian artery flow (75.4 ± 26.2 ml/min vs. 78.0 ± 28.9 ml/min vs. 75.5 ± 29.3 ml/min, respectively). The flow profile in the IMA was similarily unchanged. Conclusion: In patients in whom the coronary bypass blood flow is dependent on the left IMA, neither the quantitative flow volume nor the flow profile are altered by changes in blood flow of the subclavian artery.

1 The paper was presented at the 3rd Joint Meeting of the German, the Austrian and the Swiss Societies for Thoracic and Cardiovascular Surgery in Lucerne, February 9 - 12, 2000

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1 The paper was presented at the 3rd Joint Meeting of the German, the Austrian and the Swiss Societies for Thoracic and Cardiovascular Surgery in Lucerne, February 9 - 12, 2000

Dr. med. B. Hennen

Medizinische Klinik III (Kardiologie/Angiologie)
Universitätskliniken des Saarlandes

Kirrberger Strasse 1

66421 Homburg/Saar

Germany

Phone: 0049 6841 163351

Fax: 0049 6841 163357

Email: hennen@med-in.uni-sb.de

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