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The Journal of Thoracic and Cardiovascular Surgery, Vol 91, 405-410, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
CN Lee, TA Orszulak, HV Schaff and MP Kaye
The internal mammary artery has excellent long-term patency when used as a
conduit for coronary artery bypass, and clinical and experimental studies
have shown that blood flow through an internal mammary artery graft is
satisfactory for most coronary artery branches. Multiple distal anastomoses
from a single internal mammary artery, either with sequential anastomoses
or with a Y-graft, might require additional blood flow through the vessel,
and there has been concern that the flow capacity of the internal mammary
artery is insufficient with these techniques. To better define the
immediate postoperative flow capacity and pattern of the internal mammary
artery, we performed experiments in seven dogs in which the left internal
mammary artery was anastomosed to the circumflex coronary artery. In situ,
blood flow in the internal mammary artery was 27 ml/min. Blood flow was 63
ml/min in the circumflex coronary artery and 42 ml/min in the left anterior
descending coronary artery. After anastomosis of the left internal mammary
artery to the circumflex coronary artery, the left main coronary artery was
ligated; flow through the bypass graft increased to 92 ml/min, and systemic
hemodynamics remained stable. Isoproterenol stimulation further increased
flow through the left internal mammary artery graft to 160 ml/min. This
study suggests that the canine internal mammary artery is capable of
substantial early increase in flow and can, in fact, support the entire
left coronary circulation.
ARTICLES
Flow capacity of the canine internal mammary artery
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