Flow dynamics and wall shear stress in the left internal thoracic artery: composite arterial graft versus single graft

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Massimo LemmaCarlo Antona

Abstract

Phasic blood flow dynamics and wall shear stress (WSS) have the potential to directly modulate endothelial responses, playing an important role in the development of bypass graft occlusion. This study compares phasic blood flow velocity patterns and WSS of the left internal thoracic artery (LITA) used as a composite Y-graft (27 patients, Y-group) and as a single graft (24 patients, S-group) on the left anterior descending (LAD) coronary artery. An intravascular Doppler-tipped guide wire was used for postoperative analysis of phasic blood flow velocity. Flow velocities were recorded proximally and distally into the LITA in both groups. Digitalized spectral velocities were acquired to compute systolic peak velocity, diastolic peak velocity, and average peak velocity. The ratio of diastolic to systolic peak velocity was computed (DSVR). WSS was calculated from graft flow velocity and vessel diameter. Proximal LITA in Y-group had greater average peak velocity (APV) (p=0.000), DSVR (p=0.026), flow volume (p=0.000), WSS (p=0.02), and diameter (0.019) than S-group. There were not significant differences for the distal LITA between the two groups. The LITA shows a marked adaptability to flow dynamics. The proximal tract of the LITA in ...Continue Reading

Citations

Sep 23, 2011·The Annals of Thoracic Surgery·Vito MannacioPaolo Stassano
Aug 25, 2009·The Annals of Thoracic Surgery·Wouter Bas HalbersmaMassimo Alessandro Mariani
Oct 27, 2009·The Annals of Thoracic Surgery·Chang Young KimKi-Bong Kim
Sep 5, 2009·Current Opinion in Cardiology·Gianluigi Bisleri, Claudio Muneretto
Mar 25, 2011·Journal of Cardiovascular Medicine·Sean O Z BelloPradip K Sarkar

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