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A Coronary Active Perfusion System for Off‐pump Coronary Artery Bypass Grafting in an Experimental Porcine Model: The Relationship Between Flow Rate and Myocardial Function
Author(s) -
Doi Toshio,
Kamiya Hiroyuki,
Watanabe Go,
Misaki Takuro
Publication year - 2008
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.2008.00579.x
Subject(s) - medicine , preload , perfusion , cardiology , blood flow , hemodynamics , artery , shunt (medical) , beat (acoustics) , coronary circulation , anesthesia , physics , acoustics
We developed a coronary active perfusion system (synchronized arterial flow ensuring system [SAFE‐System]) to prevent myocardial ischemia during distal anastomosis in off‐pump coronary artery bypass grafting (CABG). The purpose of this study was to identify the relationship between the flow rate of the SAFE‐System and myocardial function. Studies were performed on pigs, which were divided into five groups: external shunt perfusion group (group A, n = 6); 0.1 mL/beat flow rate for the SAFE‐System group (group B, n = 6); 0.2 mL/beat flow rate group (group C, n = 6); 0.3 mL/beat flow rate group (group D, n = 6); and 0.4 mL/beat flow rate group (group E, n = 6). Regional myocardial blood flow and left ventricular function were monitored for 30 min. The regional myocardial blood flow in group A was severely decreased ( P < 0.001), and was significantly lower than in the other groups ( P < 0.001). The slope of the end‐systolic pressure–volume relationship, and the slope of the preload recruitable stroke work relationship in groups A, D, and E were lower than in groups B and C. As compared with the use of a passive external shunt, a coronary active perfusion system provides adequate myocardial blood flow and hemodynamics. It was possible to maintain left ventricular function when using 0.1 or 0.2 mL/beat flow rate. The use of a coronary active perfusion system appears to make the off‐pump CABG procedure safer and may increase the application of off‐pump bypass grafting.