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The Annals of Thoracic Surgery, Vol 57, 357-364, Copyright © 1994 by The Society of Thoracic Surgeons
YA Louagie, JP Haxhe, M Buche and JC Schoevaerdts
This study attempts to relate flow findings in internal mammary (IMA) and
saphenous vein coronary artery bypass grafts to postoperative outcome. From
262 patients undergoing coronary artery bypass grafting, 601
electromagnetic flow measurements were obtained in IMA and saphenous vein
grafts, and free graft flow was measured in 227 IMAs prior to grafting.
Retrograde flushing of the IMA with diluted papaverine hydrochloride
resulted in a marked increase in IMA free flow (124 +/- 4 mL/min versus 66
+/- 5 mL/min; p < 0.001). However, IMA free flow did not correlate with
electromagnetic flow measurements after grafting to the left anterior
descending coronary artery. The use of IMAs with free flows lower than 50
mL/min did not affect clinical outcome. Flow measured in saphenous vein
grafts (66 +/- 9 mL/min) with an electromagnetic flowmeter was
significantly greater (p < 0.001) than that in the IMA grafted on the
left anterior descending coronary artery (36 +/- 3 mL/min) under comparable
hemodynamic conditions. For the purpose of data analysis, patients were
separated into three groups based on increasing incidence of complications:
levels 0, 1, and 2. Patients with an uneventful outcome had a mean graft
flow at chest closure of 51 +/- 3 mL/min versus 51 +/- 4 mL/min for
patients in complication level 1 and 45 +/- 11 mL/min for patients in
complication level 2 (p = not significant). Free flow measured in a
vasodilated IMA was a poor predictor of flow into a grafted IMA and did not
affect clinical outcome. We were unable to validate any flow limit to use
of the IMA.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Intraoperative electromagnetic flowmeter measurements in coronary artery bypass grafts
Division of Cardiovascular and Thoracic Surgery, University Hospital of Mont-Godinne (Catholic University of Louvain), Yvoir, Belgium.
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