A comparative study of individual and sequential saphenous vein grafts instantaneous flow in posterior descending artery

Abstract

Objective To evaluate the mean blood flow(MF) and pulsatility index(PI) of individual and sequential saphenous vein grafts in posterior descending artery(PDA) in the same patient undergone off-pump coronary artery bypass grafting(OPCABG). Methods 140 patients with coronary artery disease were studied. Sequential surgical technique using single large saphenous vein was used in grafts of diagnostic artery(DIAG)(side-side), obtuse marginal artery(OM)(side-side), and PDA(end-side). Bulldog clamps were used to temporarily arrest the anastomoses of DIAG and OM near the large saphenous vein. Thus the sequential graft became to the single graft, the MF and PI of PDA were recorded in the simulating single graft by the transit-time flow measurement(TTFM), after that, bulldog clamps were removed and the MF and PI of PDA were recorded again in the real sequential graft. The data were compared. Six months later after surgery, coronary CTA were done in all patients in clinic. Results The MF of single graft and sequential graft was(22.5±13.1)ml/min and(22.2±12.9)ml/min(P>0.05). The PI of single graft and sequential graft was 2.43±0.94 and 2.38±0.88(P>0.05). The patency of all grafts is good in all patients after 6 months follows-up. Conclusion There ars no hemodynamic differences between individual and sequential grafts in PDA. It is reasonable that the short-term surgical result is the same in individual and sequential grafts in PDA. Key words: Coronary arteriosclerosis; Coronary artery bypass, off-pump; Instantaneous flow; Comparative study