The impact of competitive flow on distal coronary flow and on graft flow during coronary artery bypass surgery

Nikolaos Tsirikos Karapanosa, Scott H. Suddendorfa, Zhuo Li, Marianne Huebner, Lyle D. Joyce, Soon J. Park

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


To determine the impact of left anterior descending-competitive flow (LAD-CF) on distal coronary flow (LAD-DF) and on left internal mammary artery-graft flow (LIMA-GF), we performed a quantitative blood-flow analysis in a swine model of a LIMA-to-LAD coronary artery bypass graft (CABG). In six swine, a LIMA-to-LAD CABG was performed. LAD blood-flow was measured bilaterally to the LIMA-to-LAD anastomosis, in the LIMA and in the pulmonary artery (cardiac output, CO) along with the LIMA pulsatility index (LIMA-PI) and the left ventricular pressure (LVP). PreCABG measurements were followed by postCABG measurements at five levels of LAD-CF: 100%, 75%, 50%, 25% and 0% after gradually snaring down a snare placed proximally of the LAD-CF flow-probe. PreCABG CO and LVP remained unchanged postCABG. LAD-DF was reduced significantly postCABG (-33%, P<0.0001). Reduction of the LAD-CF (at 75%, 50%, 25% and 0%) resulted in significant increase of LIMA-GF (q38%, q63%, q113%, q225%, P<0.036 at all LAD-CF levels), reduced PI (6.8, 5.7, 4.1, 3.1, 2.5) with simultaneous increase of LAD-DF (q8%, PsNS, q8%, PsNS, q17%, PsNS, q50%, Ps0.0044). Decreased LAD-CF resulted in increased LADDF, increased LIMA-GF and decreased LIMA-PI. To the best of our knowledge, this is the first study where blood-flow was directly and simultaneously measured in all the components of the LIMA-to-LAD anastomosis.

Original languageEnglish (US)
Pages (from-to)993-997
Number of pages5
JournalInteractive cardiovascular and thoracic surgery
Issue number6
StatePublished - Jun 2011


  • Competitive flow
  • Coronary artery bypass graft
  • Left anterior descending
  • Left internal mammary artery

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'The impact of competitive flow on distal coronary flow and on graft flow during coronary artery bypass surgery'. Together they form a unique fingerprint.

Cite this