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

This Article Full Text Full Text (PDF) 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): Takeo Tedoriya Michio Kawasuji Naoki Sakakibara Yoh Watanabe Roland Hetzer Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tedoriya, T. Articles by Hetzer, R. Search for Related Content PubMed PubMed Citation Articles by Tedoriya, T. Articles by Hetzer, R.

Ann Thorac Surg 1998;66:477-481
© 1998 The Society of Thoracic Surgeons

---

Original articles: cardiovascular

Coronary bypass flow during use of intraaortic balloon pumping and left ventricular assist device

^a Department of Surgery (1), Kanazawa University School of Medicine, Kanazawa, Japan

Accepted for publication March 26, 1998.

Address reprint requests to Dr Kawasuji, Department of Surgery (1), Kanazawa University School of Medicine, Takaramachi 13-1, Kanazawa 920, Japan

Background. Intraaortic balloon pumping (IABP) and left ventricular assist device (LVAD) are used for left ventricular support when low cardiac output occurs after a coronary bypass operation for serious coronary artery disease. There are hemodynamic differences in blood flow in various kinds of coronary artery bypass grafts, caused by their inherent physiologic characteristics. The hemodynamic effects of left ventricular assistance with IABP and LVAD on blood flow through various coronary artery bypass grafts were investigated.

Methods. An ascending aorta-coronary bypass graft (ACB), an internal thoracic artery, and a descending aorta-coronary bypass graft were anastomosed to the left anterior descending coronary artery in a canine model. In this experimental model, the blood flow to the same coronary bed in the three types of grafts could be evaluated. Blood flow in the left anterior descending coronary artery through the three types of coronary bypass grafts was studied in this model during or in the absence of ventricular assistance.

Results. In the control study, the systolic blood flow did not differ among the three types of grafts, but the diastolic flow decreased in the following order: with the ACB, the internal thoracic artery, and the descending aorta-coronary bypass graft. The systolic flow during IABP and LVAD was similar to the control flows. Use of IABP increased the diastolic flow by 75.3% ± 12.4% of the control value in the ACB, 37.9% ± 25.0% in the internal thoracic artery, and 21.2% ± 11.4% in the descending aorta-coronary bypass graft. The LVAD increased the diastolic flow by 97.7% ± 18.7% of the control value in the ACB, 64.5% ± 25.7% in the internal thoracic artery, and 63.0% ± 27.9% in the descending aorta-coronary bypass graft. The diastolic blood flows in the left anterior descending coronary artery and the three types of grafts were significantly greater with IABP than the control values, and significantly greater with LVAD than with IABP and the control values. The degrees of increase of diastolic flows in the left anterior descending coronary artery and the ACB with IABP and LVAD were significantly greater than in the arterial grafts (p < 0.01).

Conclusions. The diastolic flows in the internal thoracic artery and descending aorta-coronary bypass graft increased less than in the native left anterior descending coronary artery and ACB during left ventricular assistance, particularly with IABP. It is important for the selection of tactics for the management of catastrophic status after coronary bypass grafting to consider the hemodynamic characteristics of the graft.

This article has been cited by other articles:

				F. Onorati, G. Santarpino, A. Rubino, L. Cristodoro, C. Scalas, and A. Renzulli Intraoperative bypass graft flow in intra-aortic balloon pump-supported patients: Differences in arterial and venous sequential conduits J. Thorac. Cardiovasc. Surg., July 1, 2009; 138(1): 54 - 61. [Abstract] [Full Text] [PDF]

				Y. Takami and H. Masumoto Effects of Intra-Aortic Balloon Pumping on Graft Flow in Coronary Surgery: An Intraoperative Transit-Time Flowmetric Study Ann. Thorac. Surg., September 1, 2008; 86(3): 823 - 827. [Abstract] [Full Text] [PDF]

				F. Onorati, A. Esposito, F. Pezzo, A. di Virgilio, P. Mastroroberto, and A. Renzulli Hospital Outcome Analysis After Different Techniques of Left Internal Mammary Grafts Harvesting Ann. Thorac. Surg., December 1, 2007; 84(6): 1912 - 1919. [Abstract] [Full Text] [PDF]

				F. Onorati, F. Pezzo, M. C. Comi, B. Impiombato, A. Esposito, M. Polistina, and A. Renzulli Radial artery graft function is not affected by age. J. Thorac. Cardiovasc. Surg., November 1, 2007; 134(5): 1112 - 1120. [Abstract] [Full Text] [PDF]

				F. Onorati, S. Olivito, P. Mastroroberto, A. di Virgilio, A. Esposito, A. Perrotti, and A. Renzulli Perioperative Patency of Coronary Artery Bypass Grafting is Not Influenced by Off-Pump Technique Ann. Thorac. Surg., December 1, 2005; 80(6): 2132 - 2140. [Abstract] [Full Text] [PDF]

				R. J.F. Baskett, W. A. Ghali, A. Maitland, and G. M. Hirsch The intraaortic balloon pump in cardiac surgery Ann. Thorac. Surg., October 1, 2002; 74(4): 1276 - 1287. [Abstract] [Full Text] [PDF]

				M. Tsuchida, Y. Yamato, T. Watanabe, H. Ohzeki, and J.-i. Hayashi Changes in graft flow pattern from the descending aorta due to intraaortic balloon pump Ann. Thorac. Surg., September 1, 2000; 70(3): 981 - 982. [Abstract] [Full Text] [PDF]