Intraoperative assessment of myocardial ischemia and adequacy of coronary bypass grafting by measuring regional myocardial blood flow
Kawasuji, M.; Kawajiri, F.; Tsujiguchi, H.; Sakakibara, N.; Watanabe, G.; Iwa, T.
Nihon Kyobu Geka Gakkai 36(7): 1116-1120
1988
ISSN/ISBN: 0369-4739 PMID: 3263450 Document Number: 313253
Regional myocardial blood flow (MBF) was measured with the electrolytic hydrogen clearance method during coronary artery bypass graft surgery to assess myocardial ischemia and to evaluate the adequacy of coronary bypass grafting. Group I had nonischemia heart disease, and Group II had ischemic heart disease. Ventricular regions supplied by coronary arteries showing < 75% and .gtoreq. 75% stenosis comprised Group IIa and IIb, respectively. Mean MBF was 156 .+-. 24, 150 .+-. 44, 105 .+-. 58 ml/min/100 g in Group I, IIa, and IIb, respectively. Mean MBF was low in the areas of coronary arteries showing .gtoreq. 90% stenosis. Mean MBF was 40 .+-. 23 and 96 .+-. 48 ml/min/100 g in the areas of anterior Q wave and non-Q vave infarction, respectively. After cardiopulmonary bypass, mean MBF increased from 104 .+-. 59 to 149 .+-. 44 ml/min/100 g in the grafted areas in Group IIb (p < 0.01). The electrolytic hydrogen clearance method provided quantitative and accurate evaluation of myocardial ischemia. This method was especially useful in patients with mammary artery grafts, and was proven to have the same efficiency in restoring MBF as saphenous vein grafts.