HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Gordon N. Olinger Donald G. Mulder James V. Maloney, Jr. Gerald D. Buckberg Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Olinger, G. N. Articles by Buckberg, G. D. Search for Related Content PubMed PubMed Citation Articles by Olinger, G. N. Articles by Buckberg, G. D.

Ann Thorac Surg 1976;21:397-404
© 1976 The Society of Thoracic Surgeons

---

Articles

Phasic Coronary Flow: Intraoperative Evaluation of Flow Distribution, Myocardial Function, and Reactive Hyperemic Response

From the Division of Thoracic Surgery, UCLA School of Medicine, Los Angeles, CA.

Accepted for publication September 29, 1975.

^* Address reprint requests to Dr. Buckberg, Division of Thoracic Surgery, UCLA Medical Center, Los Angeles, CA 90024.

Using visual inspection of phasic flow patterns and understanding their physical determinants, intraoperative decisions regarding flow distribution, function of revascularized myocardium, and collateral communications can be made. Mean flow measurements cannot provide this information. Systolic compressive forces across most of the normally contracting left ventricle limit systolic myocardial perfusion. Consequently, normal flow through the left anterior descending, left circumflex, and dominant right coronary artery (supplying the inferior left ventricle) is predominantly diastolic (> 60%) and remains so during reactive hyperemia.

Representative examples from 100 consecutive revascularizations are presented showing that when more than 40% of flow is systolic in the right coronary artery, high mean flows (> 100 ml/min) may go predominantly to the right rather than the left ventricle; in the case of the left coronary artery, high mean flow may supply myocardium undergoing infarction or replaced by scar rather than normally contracting muscle. When more than 60% of flow is diastolic without reactive hyperemia, borderline mean flow (40 to 60 ml/min) may indicate lack of distal ischemia rather than fixed distal resistance.

This article has been cited by other articles:

				H. Takemura, M. Kawasuji, N. Sakakibara, T. Tedoriya, T. Ushijima, and Y. Watanabe Internal Thoracic Artery Graft Function During Exercise Assessed by Transthoracic Doppler Echography Ann. Thorac. Surg., March 1, 1996; 61(3): 914 - 919. [Abstract] [Full Text]

				J. A. M. van Son, S. H. Skotnicki, M. B. M. Peters, N. H. J. Pijls, L. Noyez, and W. N. J. C. van Asten Noninvasive hemodynamic assessment of the internal mammary artery in myocardial revascularization Ann. Thorac. Surg., February 1, 1993; 55(2): 404 - 409. [Abstract] [PDF]

				J. T. Sturm, N. J. Snow, D. W. vanHeeckeren, J. A. Clayman, T. P. Horrigan, and J. L. Ankeney Coronary Artery Bypass Grafts: Increased Flow in the Early Postoperative Period Ann. Thorac. Surg., June 1, 1980; 29(6): 534 - 538. [Abstract] [PDF]

				P. Karkola, E. Saarela, S. Tuononen, R. Pokela, L. Nuutinen, M. I. Kairaluoma, and T. K. I. Larmi Intraoperative Changes in Coronary Resistance During Aortic Valve Replacement Ann. Thorac. Surg., May 1, 1978; 25(5): 407 - 412. [Abstract] [PDF]