Studies of blood flow in aorta-to-coronary venous bypass grafts in man.
Studies of blood flow in aorta-to-coronary venous bypass grafts in man.
复制标题
人类主动脉至冠状静脉旁路移植物血流的研究。
DOI：
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发表时间：
1972
影响因子：
15.9
通讯作者：
D. Sabiston
中科院分区：
文献类型：
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作者：
J. Greenfield;J. Rembert;W. Young;H. Oldham;J. Alexander;D. Sabiston
对57例接受单次主动脉-冠状动脉旁路手术的患者的静脉移植物进行了压力-流量测量。血流轮廓与犬的左冠状动脉血流相类似，除了在收缩期短暂的增加可能与移植物的延长有关。旁路时流量最大，旁路后30min流量稳定。在42例患者中，此时的流量为35+/-2 cm(3)/min（平均+/-sem）。血流与以下因素之间没有相关性：左移植物与右移植物、侧支存在与否、完全传导阻滞与部分传导阻滞、室性运动障碍存在与否。在32例患者中，这些解剖结果与反应性充血之间没有相关性。在17例患者中，移植物闭塞10秒导致平均51.5%的流动债务偿还。在9例患者中，向移植物中注射0.3杯异丙肾上腺素使血流在4-7秒内从45+/-6增加到69+/-9 cm(3)/min，而速率、压力、左室压时间导数（LV dp/dt）或左室舒张末期压（LVEDP）均未发生变化。注射后12-20秒最大增加至87+/-10 cm(3)/min，同时这些参数也发生变化。静脉输注去甲肾上腺素不会改变血管阻力，而苯肾上腺素则会。在6例患者中，向移植物中注射0.2杯去甲肾上腺素可使血流在5-8秒内从49+/-6减少到25+/-5 cm(3)/min。静脉滴注0.15 mg硝酸甘油可使冠状动脉阻力从2.7+/-0.4降低到2.3+/-0.3 mmhg /cm(3) /min。在5例患者中，0.12 mg硝酸甘油可使血流从46+/-7增加到71+/-13 cm(3)/min，并持续20-40秒。
Pressure-flow measurements were obtained from the vein graft of 57 patients undergoing a single aorta-to-coronary bypass procedure. The flow contour was similar to phasic left coronary artery flow in dogs except for a transient increase during systole possibly related to elongation of the graft. Flow was highest during bypass and decreased to a stable value 30 min after bypass. In 42 patients, flow at this time was 35+/-2 cm(3)/min (mean+/-sem).NO CORRELATIONS WERE DEMONSTRATED BETWEEN FLOW AND THE FOLLOWING: left vs. right grafts, presence or absence of collaterals, total vs. partial block, or the presence or absence of ventricular dyskinesis. In 32 patients, no correlation between these anatomic findings and the presence of reactive hyperemia was demonstrated. In 17 patients, occlusion of the graft for 10 sec resulted in a mean 51.5% flow debt repayment. In nine patients, injection of 0.3 mug of isoproterenol into the graft increased flow from 45+/-6 to 69+/-9 cm(3)/min within 4-7 sec without changes in rate, pressure, time derivative of left ventricular pressure (LV dp/dt), or left ventricular end diastolic pressure (LVEDP). Maximum increases to 87+/-10 cm(3)/min occurred 12-20 sec after injection with concomitant changes in these parameters. Intravenous infusion of norepinephrine did not change vascular resistance, whereas phenylephrine did. In six patients, injection of 0.2 mug of norepinephrine into the graft decreased flow from 49+/-6 to 25+/-5 cm(3)/min within 5-8 sec. Intravenous infusion of 0.15 mg of nitroglycerin decreased coronary vascular resistance from 2.7+/-0.4 to 2.3+/-0.3 mm Hg/cm(3) per min. In five patients, 0.12 mg of nitroglycerin injected into the graft increased flow from 46+/-7 to 71+/-13 cm(3)/min and lasted 20-40 sec.