Evaluation of Venous Bypass Grafts from Aorta to Coronary Artery by Inert Gas Desaturation and Direct Flowmeter Techniques

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Abstract

Blood flow through aorta-to-coronary artery bypass grafts has been measured selectively in 16 patients at or within 6 wk after operation. Inert gas desaturation curves were obtained from coronary venous blood samples after a 7-15 min infusion of dissolved H2 directly into the graft. Samples were analyzed chromatographically and curves resolved to 1-3% of initial H2 concentrations. Average flow per unit volume (F/V) was 67±21 (sd) ml/min per 100 g. Semilogarithmic plots showed F/V to be distributed heterogeneously in every case. In nine studies at operation, H2 measurements of average F/V were combined with electromagnetic measurements of total flow to estimate revascularized tissue mass. Electromagnetic flows ranged from 25 to 170 ml/min and averaged 69 ml/min. Tissue mass ranged from 46 to 155 g and averaged 88 g. We conclude that bypass grafts provide nutritive flow to significant amounts of myocardium at and shortly after operation. However, nutritive flow is not distributed evenly throughout the revascularized segment. The majority of the segment has a F/V within the accepted range of normal but there remain areas in which F/V is reduced significantly. The combination of inert gas and electromagnetic techniques allows a revascularized area to be characterized in terms of total flow, F/V, and tissue mass.

Authors

David G. Greene, Francis J. Klocke, George L. Schimert, Ivan L. Bunnell, Stephen M. Wittenberg, Thomas Lajos