ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Alistair G. Royse
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Royse, A. G.
Right arrow Articles by Yu, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Royse, A. G.
Right arrow Articles by Yu, G.

Ann Thorac Surg 1999;68:1619-1622
© 1999 The Society of Thoracic Surgeons

Original Articles

Blood flow in composite arterial grafts and effect of native coronary flow

Alistair G. Royse, FRACSa, Colin F. Royse, FANZCAb, Karen L. Groves, B Busb, Gang Yu, M App Scb

a Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne, Australia
b Department of Anaesthesia, Royal Melbourne Hospital, Melbourne, Australia

Address reprint requests to Dr Royse, Department of Cardiothoracic Surgery, Royal Melbourne Hospital, PO Box 2135, Parkville, Victoria 3050, Australia
e-mail: alistair.royse{at}nwhcn.org.au

Background. Total arterial coronary revascularization can be achieved by joining arteries together as a composite graft with the proximal left internal mammary artery as the only source of blood inflow. Proof of the capacity of this composite conduit to provide adequate blood flow to the coronary circulation is required.

Methods. The radial artery was anastomosed to the left internal mammary artery as a Y graft in 17 patients and all coronary arteries grafted. Intraoperative blood flow through the composite grafts was evaluated by the transit-time Doppler technique.

Results. Against no resistance, blood flow in the left internal mammary artery alone was 99 ± 9 mL/min and rose to 173 ± 16 mL/min when the radial artery was anastomosed as a Y graft. Composite-graft flow following grafting was 88 ± 9 mL/min, 49 ± 6 mL/min when the aortic clamp was removed and native coronary flow restored and 82 ± 13 mL/min following weaning from cardiopulmonary bypass. The maximal potential flow through the composite graft was 2.3-fold (95% CI 1.6 to 3.2) greater than that after cardiopulmonary bypass.

Conclusions. Total arterial revascularization, using a composite graft, provided a 2.3-fold reserve of blood flow to the coronary vascular bed through the grafts.




This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
D. Glineur, C. Hanet, W. D'hoore, A. Poncelet, L. De Kerchove, P. Y. Etienne, P. Noirhomme, and G. El Khoury
Causes of non-functioning right internal mammary used in a Y-graft configuration: insight from a 6-month systematic angiographic trial
Eur. J. Cardiothorac. Surg., July 1, 2009; 36(1): 129 - 136.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
W. S. Kim, J. Lee, Y. T. Lee, K. Sung, J.-H. Yang, T.-G. Jun, and P. W. Park
Total Arterial Revascularization in Triple-Vessel Disease With Off-Pump and Aortic No-Touch Technique
Ann. Thorac. Surg., December 1, 2008; 86(6): 1861 - 1865.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
E. Gongora and T. M. Sundt III
Myocardial Revascularization with Cardiopulmonary Bypass
Card. Surg. Adult, January 1, 2008; 3(2008): 599 - 632.
[Full Text]

Home page
 Eur. J. Cardiothorac. Surg.Home page
H. Nakajima, J. Kobayashi, T. Funatsu, Y. Shimahara, M. Kawamura, A. Kawamura, T. Yagihara, and S. Kitamura
Predictive factors for the intermediate-term patency of arterial grafts in aorta no-touch off-pump coronary revascularization
Eur. J. Cardiothorac. Surg., November 1, 2007; 32(5): 711 - 717.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
D. Pevni, I. Hertz, B. Medalion, A. Kramer, Y. Paz, G. Uretzky, and R. Mohr
Angiographic evidence for reduced graft patency due to competitive flow in composite arterial T-grafts
J. Thorac. Cardiovasc. Surg., May 1, 2007; 133(5): 1220 - 1225.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
H. Nakajima, J. Kobayashi, O. Tagusari, K. Niwaya, T. Funatsu, A. Brik, T. Yagihara, and S. Kitamura
Graft design strategies with optimum antegrade bypass flow in total arterial off-pump coronary artery bypass
Eur. J. Cardiothorac. Surg., February 1, 2007; 31(2): 276 - 282.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
K. R. Cho, H. Y. Hwang, W. J. Kang, D. S. Lee, and K.-B. Kim
Progressive improvement of myocardial perfusion after off-pump revascularization with bilateral internal thoracic arteries: Comparison of early versus 1-year postoperative myocardial single photon emission computed tomography
J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 52 - 57.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
H. Nakajima, J. Kobayashi, O. Tagusari, K. Niwaya, T. Funatsu, A. Kawamura, T. Yagihara, and S. Kitamura
Angiographic flow grading and graft arrangement of arterial conduits.
J. Thorac. Cardiovasc. Surg., November 1, 2006; 132(5): 1023 - 1029.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
H. B. Barner
Status of percutaneous coronary intervention and coronary artery bypass.
Eur. J. Cardiothorac. Surg., September 1, 2006; 30(3): 419 - 424.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
S. Na, Y. J. Oh, Y. H. Shim, Y. W. Hong, S. O. Bang, and Y. L. Kwak
Effects of milrinone on blood flow of the Y-graft composed with the radial and the internal thoracic artery in patients with coronary artery disease.
Eur. J. Cardiothorac. Surg., August 1, 2006; 30(2): 324 - 328.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
H. Nakajima, J. Kobayashi, O. Tagusari, K. Bando, K. Niwaya, and S. Kitamura
Functional Angiographic Evaluation of Individual, Sequential, and Composite Arterial Grafts
Ann. Thorac. Surg., March 1, 2006; 81(3): 807 - 814.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. Mussa, B. P. Choudhary, and D. P. Taggart
Reply to the Editor
J. Thorac. Cardiovasc. Surg., October 1, 2005; 130(4): 1227 - 1228.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Fukui, S. Takanashi, Y. Hosoda, and S. Suehiro
Total Arterial Myocardial Revascularization Using Composite and Sequential Grafting With the Off-Pump Technique
Ann. Thorac. Surg., August 1, 2005; 80(2): 579 - 585.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
G. Gatti, C. Bentini, G. Maffei, F. Ferrari, M. Dondi, P. Pacilli, and P. Pugliese
Noninvasive Dynamic Assessment With Transthoracic Echocardiography of a Composite Arterial Y-Graft Achieving Complete Myocardial Revascularization
Ann. Thorac. Surg., April 1, 2005; 79(4): 1217 - 1224.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. Hyun Kang, K.-B. Kim, C. Soo Park, J. Chul Paeng, and D. Soo Lee
Improvement of Myocardial Stress Perfusion After Off-Pump Revascularization Using Bilateral Internal Thoracic In Situ Grafts Versus Y-Composite Grafts
Ann. Thorac. Surg., January 1, 2005; 79(1): 93 - 98.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. G. Affleck, H. B. Barner, M. S. Bailey, L. A. Perry, H. Maniar, S. M. Prasad, and R. J. Damiano Jr
Flow Dynamics of the Internal Thoracic and Radial Artery T-Graft
Ann. Thorac. Surg., October 1, 2004; 78(4): 1290 - 1294.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
O. Tagusari, J. Kobayashi, K. Bando, K. Niwaya, H. Nakajima, T. Nakatani, T. Yagihara, and S. Kitamura
Total Arterial Off-Pump Coronary Artery Bypass Grafting for Revascularization of the Total Coronary System: Clinical Outcome and Angiographic Evaluation
Ann. Thorac. Surg., October 1, 2004; 78(4): 1304 - 1311.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
H. Nakajima, J. Kobayashi, O. Tagusari, K. Bando, K. Niwaya, and S. Kitamura
Competitive flow in arterial composite grafts and effect of graft arrangement in Off-Pump coronary revascularization
Ann. Thorac. Surg., August 1, 2004; 78(2): 481 - 486.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. Rukosujew, R. Reichelt, A. M. Fabricius, G. Drees, T. D. T. Tjan, M. Rothenburger, A. Hoffmeier, H. H. Scheld, and C. Schmid
Skeletonization versus pedicle preparation of the radial artery with and without the ultrasonic scalpel
Ann. Thorac. Surg., January 1, 2004; 77(1): 120 - 125.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. F. Legare, K. J. Buth, J. A. Sullivan, and G. M. Hirsch
Composite arterial grafts versus conventional grafting for coronary artery bypass grafting
J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 160 - 166.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Gaudino, M. Di Mauro, A. L. Iaco, C. Canosa, G. Vitolla, and A. M. Calafiore
Immediate flow reserve of Y thoracic artery grafts: an intraoperative flowmetric study
J. Thorac. Cardiovasc. Surg., October 1, 2003; 126(4): 1076 - 1079.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
M. Lemma, A. Mangini, G. Gelpi, A. Innorta, P. Danna, F. Lavarra, E. Piccaluga, and C. Antona
Effects of heart rate on phasic Y-graft blood flow and flow reserve in patients with complete arterial myocardial revascularizaton: an intravascular Doppler catheter study
Eur. J. Cardiothorac. Surg., July 1, 2003; 24(1): 81 - 85.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
D. Pevni, R. Mohr, O. Lev-Ran, Y. Paz, A. Kramer, I. Frolkis, and I. Shapira
Technical Aspects of Composite Arterial Grafting With Double Skeletonized Internal Thoracic Arteries
Chest, May 1, 2003; 123(5): 1348 - 1354.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. Haase, A. Sharma, A. Fielitz, S. Uchino, J. Rocktaeschel, R. Bellomo, L. Doolan, G. Matalanis, A. Rosalion, B. F. Buxton, et al.
On-pump coronary artery surgery versus off-pump exclusive arterial coronary grafting: a matched cohort comparison
Ann. Thorac. Surg., January 1, 2003; 75(1): 62 - 67.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
Y. J. Woo and T. J. Gardner
Myocardial Revascularization with Cardiopulmonary Bypass
Card. Surg. Adult, January 1, 2003; 2(2003): 581 - 607.
[Full Text]

Home page
 Ann. Thorac. Surg.Home page
K.-B. Kim, K. R. Cho, W.-I. Chang, C. Lim, B. M. Ham, and Y. L. Kim
Bilateral skeletonized internal thoracic artery graftings in off-pump coronary artery bypass: early result of Y versus in situ grafts
Ann. Thorac. Surg., October 1, 2002; 74(4): S1371 - 1376.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
G. Sakaguchi, E. Tadamura, M. Ohnaka, K. Tambara, K. Nishimura, and M. Komeda
Composite arterial Y graft has less coronary flow reserve than independent grafts
Ann. Thorac. Surg., August 1, 2002; 74(2): 493 - 496.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
L. R. Sajja and G. Mannam
Right internal mammary artery and radial artery composite in situ pedicle graft in coronary artery bypass grafting
Ann. Thorac. Surg., June 1, 2002; 73(6): 1856 - 1859.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
J. B. Christensen, J. T. Lund, E. Kassis, and H. Kelbaek
Complete arterial coronary revascularisation using radial artery conduit for double thoracic artery inlet flow: arterial sling operation
Eur. J. Cardiothorac. Surg., March 1, 2002; 21(3): 391 - 394.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. Ochi, N. Hatori, R. Bessho, M. Fujii, Y. Saji, S. Tanaka, and H. Honma
Adequacy of flow capacity of bilateral internal thoracic artery T graft
Ann. Thorac. Surg., December 1, 2001; 72(6): 2008 - 2011.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
O. Lund, J. Christensen, S. Holme, K. Fruergaard, A. Olesen, E. Kassis, and U. Abildgaard
On-pump versus off-pump coronary artery bypass: independent risk factors and off-pump graft patency
Eur. J. Cardiothorac. Surg., November 1, 2001; 20(5): 901 - 907.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
G. Vitolla, G. Di Giammarco, G. Teodori, V. Mazzei, C. Canosa, M. Di Mauro, S. D'Alessandro, and A. M. Calafiore
Composite lengthened arterial conduits: Long-term angiographic results of an uncommon surgical strategy
J. Thorac. Cardiovasc. Surg., October 1, 2001; 122(4): 687 - 690.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
O. Lev-Ran, D. Pevni, M. Matsa, Y. Paz, A. Kramer, and R. Mohr
Arterial myocardial revascularization with in situ crossover right internal thoracic artery to left anterior descending artery
Ann. Thorac. Surg., September 1, 2001; 72(3): 798 - 803.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
D. Pevni, A. Kramer, Y. Paz, O. Lev-Run, C. Locker, M. Matsa, I. Shapira, and R. Mohr
Composite arterial grafting with double skeletonized internal thoracic arteries
Eur. J. Cardiothorac. Surg., August 1, 2001; 20(2): 299 - 304.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
A. M. Calafiore, M. Contini, G. Vitolla, M. Di Mauro, V. Mazzei, G. Teodori, and G. Di Giammarco
Bilateral internal thoracic artery grafting: Long-term clinical and angiographic results of in situ versus Y grafts
J. Thorac. Cardiovasc. Surg., November 1, 2000; 120(5): 990 - 998.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. G. Royse, C. F. Royse, K. L. Groves, and G. Yu
Reply
Ann. Thorac. Surg., July 1, 2000; 70(1): 341 - 342.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
O. Wendler and H.-J. Schafers
Have they really seen the effect of the native coronary blood flow?
Ann. Thorac. Surg., July 1, 2000; 70(1): 341 - 341.
[Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
A. G. Royse, C. F. Royse, J. Tatoulis, L. E. Grigg, P. Shah, D. Hunt, N. Better, and S. F. Marasco
Postoperative radial artery angiography for coronary artery bypass surgery
Eur. J. Cardiothorac. Surg., March 1, 2000; 17(3): 294 - 304.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1999 by The Society of Thoracic Surgeons.