What question did this study set out to answer?

To determine whether coronary artery bypass surgery restores normal maximal coronary flow reserve and evaluate the limiting effects of diffuse atherosclerosis, anastomotic stenosis, and myocardial condition.

September 1, 1987Circulation

Does coronary artery bypass surgery restore normal maximal coronary flow reserve? The effect of diffuse atherosclerosis and focal obstructive lesions.

View Full Paper

Ask AI

Bookmark

Why the study?

Does coronary artery bypass surgery restore normal maximal coronary flow reserve in patients with bypass grafts compared to normal coronary vessels?

Key Points

To determine whether coronary artery bypass surgery restores normal maximal coronary flow reserve and evaluate the limiting effects of diffuse atherosclerosis, anastomotic stenosis, and myocardial condition.
Assessed coronary flow reserve in 24 patients with 35 bypass grafts and compared them with 13 control subjects with normal coronary arteries and myocardium.
Measured blood velocity using a subselective Doppler catheter following papaverine-induced maximal hyperemia and assessed lumen dimensions with quantitative coronary angiography.
Bypass grafts perfusing unobstructed anastomoses and normal myocardium achieved normal coronary flow reserve (5.0 ± 0.4 vs. 5.1 ± 0.6 in controls), despite a 40% reduction in the cross-sectional area of the native artery distal to the graft.
Bypass grafts perfusing hypertrophied (n = 2) or infarcted (n = 6) myocardium demonstrated significantly reduced flow reserve (2.7 ± 0.3 vs. 5.1 ± 0.6; p < 0.01), even in myocardium with minimal hypokinesis.

Structured PICO

Does coronary artery bypass surgery restore normal maximal coronary flow reserve in patients with bypass grafts compared to normal coronary vessels?

Population

24 patients with 35 bypass grafts perfusing angiographically normal coronary vessels

Intervention

Coronary artery bypass surgery (assessed via Doppler catheter measurement of coronary flow reserve after papaverine injection)

Comparator

13 patients with normal coronary vessels and normal myocardium

Outcome

Coronary flow reserve (peak/resting velocity ratio)surrogate

Coronary artery bypass surgery restores normal maximal coronary flow reserve in grafts perfusing unobstructed anastomoses and normal myocardium, but not in those perfusing hypertrophied or infarcted myocardium.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Normal CFR post-CABG limited to grafts perfusing normal myocardium; leaves open viability assessment before revascularization in observational data.

Cite This Study

Wilson et al. (1987) studied this question.

synapsesocial.com/papers/6a9d2be7f38c20636a48a4de https://doi.org/10.1161/01.cir.76.3.563

View Full Paper

Ask AI

Bookmark

Implication

Normal CFR post-CABG limited to grafts perfusing normal myocardium; leaves open viability assessment before revascularization in observational data.

Does coronary artery bypass surgery restore normal maximal coronary flow reserve? The effect of diffuse atherosclerosis and focal obstructive lesions.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Does coronary artery bypass surgery restore normal maximal coronary flow reserve? The effect of diffuse atherosclerosis and focal obstructive lesions.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider