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Oxford University Press, Interactive Cardiovascular and Thoracic Surgery, 2(15), p. 288-289

DOI: 10.1093/icvts/ivs152

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Competitive flow between a vein and an arterial graft at transit-time flow measurement

Journal article published in 2012 by Michele Rossi, Federica Jiritano ORCID, Emanuele Malta, Attilio Renzulli
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Data provided by SHERPA/RoMEO

Abstract

We report the intraoperative finding, at a transit-time flow measurement, of competitive flow between a venous and an arterial graft in a 72-year old woman who underwent uncomplicated coronary artery bypass grafting × 3. The blood flow in the left internal mammary artery (LIMA) improved only after temporary occlusion of the saphenous vein graft (SVG) anastomosed to the first diagonal (D1), demonstrating the presence of competitive flow from the SVG-D1 anastomosis into the LIMA–left anterior descending coronary artery (LAD) system. Interestingly the two target vessels suffered from separate critical lesions. The patient's haemodynamics remained stable throughout and no further action was taken. Her recovery was uneventful and the patient was discharged home on postoperative day 6. This case raised questions about the cost benefit of grafting a diagonal target even when it appeared to be disconnected from the LAD on a coronary angiogram.