Cardiac pacing induced flow responses in internal thoracic artery and saphenous vein coronary artery bypass grafts.
The flow reactivity of an internal thoracic artery (ITA) graft and a vein graft for multiple coronary beds in response to different modes of cardiac pacing remains unclear. These experiments were conducted in 14 anesthetized dogs with the ITA or the vein grafted to the circumflex coronary artery, off pump, using a brief local occlusion. The left main coronary artery was occluded, rendering the entire left ventricle totally dependent upon the ITA graft or the vein graft. When the left main coronary artery was occluded and the heart rate was 120 beats per min, graft flow was 93.4 +/- 9.6 ml per min in the ITA, and 96.1 +/- 10.4 ml per min in the vein graft. Atrial pacing to increase heart rates 25% to 150 beats per min increased both the ITA graft flow (110.3 +/- 9.7 ml per min, p < 0.05 versus flow in sinus rhythm) and the vein graft flow (109.8 +/- 7.9 ml per min, p < 0.05 versus flow in sinus rhythm). The increases in flow in both cases were not attributable to changes in perfusion pressure. In contrast, ventricular pacing to the same heart rate decreased systemic pressure slightly, but insignificantly. Despite the slight decrease in perfusion pressure, ventricular pacing increased ITA flow (107.9 +/- 8.4 ml per min, p < 0.05 versus flow in sinus rhythm), but the increase in vein graft flow was not significant compared with flow in sinus rhythm (102.1 +/- 7.3 ml per min, p = ns versus flow in sinus rhythm).(ABSTRACT TRUNCATED AT 250 WORDS)
Otaki
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Department of Surgery, East Carolina University School of Medicine, Greenville, North Carolina 27858-4354, USA.
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Norton
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Chitwood
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D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002304:Cardiac Pacing, Artificial; D001026:Coronary Artery Bypass; D003326:Coronary Circulation / Q000502:physiology*; D004285:Dogs; D006339:Heart Rate / Q000502:physiology; D012501:Saphenous Vein / Q000502:physiology* / Q000637:transplantation; D013895:Thoracic Arteries / Q000502:physiology* / Q000637:transplantation