Thorac Cardiovasc Surg 2012; 60 - PP57
DOI: 10.1055/s-0031-1297704

Comparision of flow analysis in T- Graft, Y- Graft and Omega-Graft for myocardrevascularization

A Abugameh 1, H Weiler 1, S Meinardus 1, LO Conzelmann 1, CF Vahl 1
  • 1Universitätsmedizin Mainz, Klinik und Poliklinik für Herz-, Thorax- und Gefäßchirurgie, Mainz, Germany

Objectives: The concept of complete arterial revascularization (CAR) includes three strategies of competing anastomotic techniques: T-graft, Y-Graft and Omega-Graft. Due to that concept bloodflow of left internal thoracic artery is splitted to various outflow regions. For the purpose of intraoperative evaluation of graft quality, bloodflow measurement is standard in coronary bypass surgery. Referring to this, transit time flowmeter (TTFM) is a widely accepted technique of intraoperative graft assessment. Until today it remains unclear whether there are differences in blood flow and patency in the T-, Y- and Omega-subgroups. The present study's aim is to evaluate the blood flow in the different bypass techniques.

Methods: 60 consecutive patients suffering from left main artery disease who underwent CAR (2 distal anastomoses) were evaluated retrospectively. Intraoperative no major complications occurred. Each 20 patients was either treated with T-, Y- or Omega-Graft (n=20 per group).

After weaning from extracorporal circulation and an equilibration period of at least 10 minutes (mean arterial pressure 60–65mmHg) the transit time probe were placed around the proximal part of left internal thoracic artery corresponding the “neo-left main artery”.

Significant group effects were confirmed by analysis of variance (ANOVA) and Bonferroni error protection with a significance level at p<0.05.

Results: The highest blood flow in the “neo-left-main-artery” was observed in the T-Graft-group (117.2ml/min±48.9ml/min, p<0.05), followed by the Y-graft group (103.6ml/m±45.2ml/h). The Omega-graft-Group came in last (85.4ml/min±30.4ml/min).

However the differences failed hereby significant but they may indicate an important trend.

Conclusion: There is a trend suggesting that the T-Graft represents the superior concept of CAR in the present patient group. We could documented distinct differences in blood flow. We assume that anastomotic technique and subsequent flow characteristics are not inconsiderable influence for graft flow characteristics. Future studies have to evaluate further differences (e.g. patency) between these groups.