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Research Article Free access | 10.1172/JCI107072

Myocardial Blood Flow in Man: Effects of Coronary Collateral Circulation and Coronary Artery Bypass Surgery

Sidney C. Smith Jr., Richard Gorlin, Michael V. Herman, Warren J. Taylor, and John J. Collins Jr.

Cardiovascular Division, Department of Medicine, Peter Bent Brigham Hospital, Boston, Massachusetts 02115

Division of Thoracic and Cardiac Surgery, Department of Surgery, Peter Bent Brigham Hospital, Boston, Massachusetts 02115

Harvard Medical School, Boston, Massachusetts 02115

Find articles by Smith, S. in: PubMed | Google Scholar

Cardiovascular Division, Department of Medicine, Peter Bent Brigham Hospital, Boston, Massachusetts 02115

Division of Thoracic and Cardiac Surgery, Department of Surgery, Peter Bent Brigham Hospital, Boston, Massachusetts 02115

Harvard Medical School, Boston, Massachusetts 02115

Find articles by Gorlin, R. in: PubMed | Google Scholar

Cardiovascular Division, Department of Medicine, Peter Bent Brigham Hospital, Boston, Massachusetts 02115

Division of Thoracic and Cardiac Surgery, Department of Surgery, Peter Bent Brigham Hospital, Boston, Massachusetts 02115

Harvard Medical School, Boston, Massachusetts 02115

Find articles by Herman, M. in: PubMed | Google Scholar

Cardiovascular Division, Department of Medicine, Peter Bent Brigham Hospital, Boston, Massachusetts 02115

Division of Thoracic and Cardiac Surgery, Department of Surgery, Peter Bent Brigham Hospital, Boston, Massachusetts 02115

Harvard Medical School, Boston, Massachusetts 02115

Find articles by Taylor, W. in: PubMed | Google Scholar

Cardiovascular Division, Department of Medicine, Peter Bent Brigham Hospital, Boston, Massachusetts 02115

Division of Thoracic and Cardiac Surgery, Department of Surgery, Peter Bent Brigham Hospital, Boston, Massachusetts 02115

Harvard Medical School, Boston, Massachusetts 02115

Find articles by Collins, J. in: PubMed | Google Scholar

Published October 1, 1972 - More info

Published in Volume 51, Issue 10 on October 1, 1972
J Clin Invest. 1972;51(10):2556–2565. https://doi.org/10.1172/JCI107072.
© 1972 The American Society for Clinical Investigation
Published October 1, 1972 - Version history
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Abstract

The effects of coronary artery bypass graft (CAB) and coronary collaterals (CC) on myocardial blood flow (MBF) were studied in 24 patients undergoing 29 CAB's. MBF after CAB was compared to preexisting MBF by intraoperatively injecting 133xenon via distal CAB with proximal CAB first occluded then open. Pressure gradients across bypassed obstructions were measured. The results were correlated with preoperative coronary arteriograms to determine the effects of CC on MBF and postobstructive perfusion pressures. Mean MBF was increased by CAB from 32±6 (se) ml/min per 100 g (CAB occluded) to 118±13 ml/min per 100 g (CAB open). The 133Xe clearance curves with CAB open were resolved into slow (19±2 ml/min per 100 g) and rapid (133±12 ml/min per 100 g) phases, suggesting that MBF remained heterogeneous after CAB. Vessels with less than 80% stenosis by angiography had pressure gradients less than 20 mm Hg across obstructions, high postobstructive perfusion pressures (75±7 mm Hg), and normal MBF (87±6 ml/min per 100 g) even with CAB occluded. Vessels with greater than 80% stenosis or total occlusion by angiography had significant pressure gradients with marked reduction of postobstructive MBF. No significant difference in postobstructive MBF was found when vessels with CC (21±4 ml/min per 100 g) were compared to those without CC (17±4 ml/min per 100 g) (P > 0.4).

These studies demonstrate that (a) mean MBF increased 268% after CAB, (b) heterogeneous MBF persisted after CAB, (c) CC were not associated with significant increases in MBF, and (d) vessels with less than 80% stenosis had less than 20 mm Hg gradient with minimal effect on resting MBF.

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