Sympathetic stimulation increases the blood flow through the in situ right gastroepiploic artery graft after off-pump coronary artery bypass graft surgery☆

Abstract

The right gastroepiploic artery is gaining popularity as an in situ arterial graft for coronary artery bypass surgery. Unlike the internal thoracic artery, the right gastroepiploic artery is a visceral artery and has a vasoconstrictive tendency in response to sympathetic stimulation. We hypothesized that blood flow through the in situ right gastroepiploic arterial graft might be compromised after sympathetic stimulation. Thirty patients scheduled for off-pump coronary artery bypass surgery using the left internal thoracic artery and the right gastroepiploic artery as in situ arterial grafts were enrolled. Blood flow through both arteries was measured by transit time flow before (T1), during (T2), and after noradrenalinee infusion (T3). After sympathetic stimulation, blood flow of both the right gastroepiploic artery (30.1+/-13.9 mL/min at T1 vs 36.2+/-17.5 mL/min at T2; P = 0.001) and left internal thoracic artery grafts (37.3+/-19.1 mL/min at T1 vs 41.8+/-18.2 mL/min at T2; P = 0.01) was increased significantly. However, blood flow in proportion to cardiac output increased only in the right gastroepiploic artery graft (P = 0.01). Sympathetic stimulation increases, rather than compromises, blood flow through the right gastroepiploic artery graft after coronary revascularization.