Retrograde internal mammary to coronary artery anastomoses

Détails

ID Serval
serval:BIB_3C91691B5240
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Retrograde internal mammary to coronary artery anastomoses
Périodique
Thoracic and Cardiovascular Surgeon
Auteur⸱e⸱s
von Segesser  L., Lehmann  K., Turina  M.
ISSN
0171-6425
Statut éditorial
Publié
Date de publication
06/1989
Peer-reviewed
Oui
Volume
37
Numéro
3
Pages
143-6
Notes
Journal Article --- Old month value: Jun
Résumé
In an effort to expand the utilization of the internal mammary artery (IMA) for revascularization of the distal coronary artery branches, distally pedicled retrograde internal mammary arteries (retro-IMA) were evaluated in 10 mongrel dogs with a mean weight of 38 +/- 13 kg. One IMA was transected at it's origin (retro-IMA) and compared to the contralateral IMA which was transected at the level of the 5th intercostal space. At a mean systemic pressure of 68 +/- 15 mmHg the mean pressure measured at the tip of the IMAs with antegrade flow was 63 +/- 14 mmHg in the retro-IMAs with retrograde flow (p less than 0.05; pressure ratio 0.8). With the same mean systemic pressure, mean antegrade free flow of the IMAs was assessed 97 +/- 43 ml/min versus 48 +/- 13 ml/min in the retro-IMAs with retrograde flow (p less than 0.005; flow ratio 0.5). Left retro-IMA to coronary artery anastomosis was performed in 6 animals to the distal left anterior descending (LAD) coronary artery and in 2 animals to the distal left obtuse marginal branch. Right retro-IMA to coronary artery anastomosis to the right posterior descending coronary artery was performed in 2 animals. The LAD coronary artery was ligated proximally to the retro-IMA to coronary artery anastomosis while the retro-IMA remained crossclamped. After documentation of significant ischemia (EKG, left atrial pressure), the crossclamp of the retro-IMA graft was removed. Subsequent normalisation of EKG and left atrial pressure occurred in all animals. We conclude that the canine retro-IMA delivers significant retrograde flow and discuss a possible use in humans.
Mots-clé
*Anastomosis, Surgical Animals Blood Pressure Coronary Disease/etiology/physiopathology Coronary Vessels/*surgery Dogs Electrocardiography Ligation Mammary Arteries/physiology/*surgery Postoperative Period Regional Blood Flow Thoracic Arteries/*surgery
Pubmed
Web of science
Création de la notice
14/02/2008 15:18
Dernière modification de la notice
20/08/2019 14:32
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