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J Thorac Cardiovasc Surg 1999;118:330-338
© 1999 Mosby, Inc.

SURGERY FOR ACQUIRED CARDIOVASCULAR DISEASE

INTRAOPERATIVE HEMODYNAMIC ASSESSMENT OF GASTROEPIPLOIC ARTERY AND SAPHENOUS VEIN BYPASS GRAFTS: A COMPARATIVE STUDY

Yves A. G. Louagie, MD, PhD, Jacques Jamart, MD, Michel Buche, MD, Philippe Eucher, MD, Paul van San, Eng, Serge Theys, MSc, Jean-Claude Schoevaerdts, MD

From the Divisions of Cardiovascular and Thoracic Surgery, Biostatistics, and Vascular Laboratory of the University Clinics of Mont Godinne, Université Catholique de Louvain, Mont-Yvoir, Belgium.

Address for reprints: Yves Louagie, MD, Cardiovascular and Thoracic Surgery, University Hospital of Mont Godinne, 1 av Therasse, B-5530 Mont-Yvoir, Belgium.

Objective: Blood flow characteristics of right gastroepiploic artery and saphenous vein conduits were compared during bypass surgery.
Methods: This study is based on a consecutive series of 97 patients undergoing a bypass graft to the right coronary artery, posterior descending artery, or posterolateral branch using either a pediculated right gastroepiploic artery (n = 52) or a saphenous vein (n = 45) bypass graft. Flows and velocity profiles were measured with an 8-MHz pulsed-wave Doppler ultrasound flowmeter. Thorough flow measurements were made (1) after cessation of cardiopulmonary bypass and (2) before chest closure.
Results: At the end of cardiopulmonary bypass, flow in the right gastroepiploic artery (59.0 ± 6.7 mL/min) did not differ (P = .08) from flow in the saphenous vein (46.1 ± 2.7 mL/min). Mean trace velocity was 11.9 ± 0.7 cm/s in the right gastroepiploic artery and 11.6 ± 0.8 cm/s in the saphenous vein (P = .80), but peak systolic velocity was 29.4 ± 1.2 cm/s for the right gastroepiploic artery and 23.1 ± 1.3 cm/s for the saphenous vein (P < .001). Likewise, before chest closure, flow was 57.1 ± 4.7 mL/min in the right gastroepiploic artery and 46.5 ± 4.0 mL/min in the saphenous vein (P = .10), mean velocity was 12.9 ± 0.7 and 11.6 ± 0.8 cm/s, respectively (P = .22), and systolic peak velocity was 30.0 ± 1.2 and 22.3 ± 1.2 cm/s, respectively (P < .001).
Conclusions: There were no flow differences between right gastroepiploic artery and saphenous vein grafts implanted into the same coronary bed in comparable groups of patients. Waveform shape of the right gastroepiploic artery grafts was characterized by a wider spectral dispersion resulting in a higher maximal frequency.






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