The Annals of Thoracic Surgery, Vol 29, 534-538, Copyright © 1980 by The Society of Thoracic Surgeons
Coronary artery bypass grafts: increased flow in the early postoperative period
JT Sturm, NJ Snow, DW vanHeeckeren, JA Clayman, TP Horrigan and JL Ankeney
The long-term outcome of coronary artery bypass operations is contingent
upon the patency of aortocoronary bypass grafts. Flow measurements taken at
operation may not truly reflect the capacity of the graft to carry glow
because the heart may not have fully recovered from the consequences of
ischemic arrest, despite the protective effects of hypothermic
cardioplegia. During a three-year period, we observed increases of up to
200% in the flow rate of 8 of 11 saphenous vein grafts in 7 patients who
underwent reoperation for bleeding or cardiac tamponade in the early
postoperative period. At initial operation, flow rates ranged from 25
ml/min to 130 ml/min (mean value, 66.8 +/- 10.3 ml/min [standard error of
the mean]). At reexploration, flow measurements ranged from 0 ml/min (graft
clotted) to 260 ml/min (mean value, 110 +/- 22.8 ml/min). This difference
was statistically significant (p less than 0.02). This study documents that
flow rate measurements in saphenous vein aorotocoronary bypass grafts can
increase in the early postoperative period although the exact mechanism by
which this occurs is not known.