Bronchopulmonary Anastomotic and Noncoronary Collateral Blood Flow in Humans during Cardiopulmonary Bypass

Abstract

The sole source of blood returning to the left atrium during cardiopulmonary bypass, while the aorta is cross-clamped, is the bronchopulmonary anastomotic blood flow. In addition, there is noncoronary collateral blood flow which returns to the right atrium. Routinely, the bronchopulmonary anastomotic flow is drained from the left ventricle by a cannula and returned to the main circuitry via a cardiotomy reservoir. The noncoronary collateral flow may be vented similarly by introducing a cannula into the right atrium. Both the anastomotic and the noncoronary collateral flow can be measured with no further surgical intervention. We measured bronchopulmonary anastomotic flow in 40 patients undergoing coronary artery bypass surgery and the noncoronary collateral blood flow in 27 of these patients. Results from this study show that the bronchopulmonary anastomotic flow for the 40 patients was 140 +/- 182 ml/min (range 8 to 1,043 ml/min), representing 3.23 +/- 4.15 percent of the pump flow (equivalent to the cardiac output), and the noncoronary collateral flow in the 27 patients was 48 +/- 74 ml/min (range 0 to 261 ml/min), representing 1.11 +/- 1.67 percent of the pump flow.