Intraoperative evaluation of coronary bypass grafts by measuring myocardial blood flow using the electrolytic hydrogen clearance method.

Abstract

The regional myocardial blood flow (MBF) was measured in 33 patients who underwent coronary bypass graft surgery in order to evaluate the efficiency of coronary bypass grafts in restoring MBF. MBF was measured by the electrolytic hydrogen clearance method during the coronary bypass surgery. The mean prebypass MBF was 161 +/- 19, 162 +/- 12, 80 +/- 12, 43 +/- 14, 104 +/- 18 ml/min/100 g in segments supplied by the left anterior descending coronary artery (LAD) showing less than or equal to 50 per cent, 75 per cent, 90 per cent, 99 per cent, and 100 per cent stenosis with collaterals, respectively. After bypass grafting of the LAD, the mean MBF increased from 70 +/- 13 and 126 +/- 12 ml/min/100 g to 133 +/- 14 and 163 +/- 9 ml/min/100 g in the segments with and without infarction, respectively. The mean postbypass MBF was 149 +/- 10 and 152 +/- 14 ml/min/100 g in the segments supplied by the LAD bypassed with saphenous vein grafts and mammary artery grafts, respectively. Postbypass MBF was dependent upon the magnitude of myocardial infarction. Measurement of MBF by the electrolytic hydrogen clearance method made it possible to quantitatively evaluate myocardial perfusion at the time of operation. It also provided direct information about the effectiveness of myocardial revascularization.