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Ann Thorac Surg 1997;64:426-431
© 1997 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Intraoperative Blood Flow Measurement of the Right Gastroepiploic Artery Using Pulsed Doppler Echocardiography

Giuseppe Tavilla, MD, Jack Jackimovicz, MD, PhD, Eric Berreklouw, MD, PhD

Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, and Departments of General Surgery and Cardiothoracic Surgery, Catharina Hospital, Eindhoven, the Netherlands

Accepted for publication February 4, 1997.

Background. In coronary artery revascularization, the right gastroepiploic artery (GEA) has become the third arterial conduit of choice after both internal thoracic arteries. To evaluate the function of the right GEA, we used intraoperative ultrasonographic Doppler measurement of the blood flow of this artery.

Methods. From November 1992 to December 1993, in 41 consecutive patients, graft flow velocity, diameter, and blood flow were measured in the proximal part of the GEA before takedown and after completion of the anastomosis just before sternal closure. We also analyzed the predictors of postoperative ischemia.

Results. Flow volume of the GEA after anastomosis with the coronary artery has a significant correlation with the diameter of the target coronary artery (p = 0.0011). Two patients had development of ischemia postoperatively. In both, volume flow of the GEA was less than 25 mL/min before takedown compared with an average flow of 55.78 mL/min in the patients without ischemia postoperatively. This was found to be a prognostic indicator of poor graft performance with consequent ischemia.

Conclusions. When the GEA blood flow volume before takedown is less than 25 mL/min, we suggest that this artery not be used as a bypass graft for myocardial revascularization.


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Invited Commentary
Guo-Wei He
Ann. Thorac. Surg. 1997 64: 431. [Extract] [Full Text]



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