Coronary grafts flow and cardiac pacing modalities: how to improve perioperative myocardial perfusion.
Ramesh, B C
Chughtai, Jehan Zeb
Anjum, Muhammad Nadeem
AffiliationDepartment of Cardiac Surgery, Cork University Hospital, Cork, Ireland., firstname.lastname@example.org
MeSHCardiac Pacing, Artificial/*methods
Coronary Artery Bypass/*methods
MetadataShow full item record
CitationEur J Cardiothorac Surg. 2004 Jul;26(1):85-8.
JournalEuropean journal of cardio-thoracic surgery : official journal of the European, Association for Cardio-thoracic Surgery
AbstractOBJECTIVE: Aim of this study was to investigate modifications of coronary grafts flow during different pacing modalities after CABG. MATERIALS AND METHODS: Two separate prospective studies were conducted in patients undergoing CABG and requiring intraoperative epicardial pacing. In a first study (22 patients) coronary grafts flows were measured during dual chamber pacing (DDD) and during ventricular pacing (VVI). In a second study (10 patients) flows were measured during DDD pacing at different atrio-ventricular (A-V) delay periods. A-V delay was adjusted in 25 ms increments from 25 to 250 ms and flow measurements were performed for each A-V delay increment. A transit time flowmeter was used for the measurements. RESULTS: An average of 3.4 grafts/patient were performed. In the first study, average coronary graft flow was 47.4+/-20.8 ml/min during DDD pacing and 41.8+/-18.2 ml/min during VVI pacing (P = 0.0004). Furthermore average systolic pressure was 94.3+/-10.1 mmHg during DDD pacing and 89.6+/-12.2 mmHg during VVV pacing (P = 0.0007). No significant differences in diastolic pressure were recorded during the two different pacing modalities. In the second study, maximal flows were achieved during DDD pacing with an A-V delay of 175 ms (54+/-9.6 ml/min) and minimal flows were detected at 25 ms A-V delay (38.1+/-4.7 ml/min) (P=ns). No significant differences in systolic or diastolic blood pressure were noticed during the different A-V delays. CONCLUSION: Grafts flowmetry provides an extra tool to direct supportive measures such as cardiac pacing after CABG. DDD mode with A-V delay around 175 ms. should be preferred to allow for maximal myocardial perfusion via the grafts.
- Temporary epicardial ventricular stimulation in patients with atrial fibrillation: acute effects of ventricular pacing site on bypass graft flows.
- Authors: Madershahian N, Liakopoulos OJ, Wittwer T, Wippermann J, Kuhn-Regnier F, Naraghi H, Wahlers T
- Issue date: 2009 Jul-Aug
- [The effect of changes in stroke volume on QT dispersion during long-term DDD and VVI pacing].
- Authors: Lelakowski J, Majewski J, Bednarek J, Szczepkowski J, Machejek J
- Issue date: 2001
- [Influence of cardiac pacing on graft flow following aortocoronary bypass surgery--comparison of ventricular and atrial pacing].
- Authors: Yoshida H
- Issue date: 1991 Mar
- Impact of pacing modality and biventricular pacing on cardiac output and coronary conduit flow in the post-cardiotomy patient.
- Authors: Healy DG, Hargrove M, Doddakulla K, Hinchion J, O'Donnell A, Aherne T
- Issue date: 2008 Oct
- A comparison of transit-time flowmetry and intraoperative fluorescence imaging for assessing coronary artery bypass graft patency.
- Authors: Balacumaraswami L, Abu-Omar Y, Choudhary B, Pigott D, Taggart DP
- Issue date: 2005 Aug