INTRAOPERATIVE ASSESSMENT OF CORONARY-ARTERY BYPASS GRAFTS USING A PULSED DOPPLER FLOWMETER

A pulsed Doppler flowmeter was used in a series of 352 consecutive pat ients undergoing isolated coronary artery bypass grafting. Doppler flo w measurements were available on 909 single terminolateral bypass graf ts (327 internal mammary arteries and 582 saphenous veins) and 58 sequ ential bypass grafts anastomosed to combinations of arteries. Flow (mL /min) categorized as a function of the recipient artery was distribute d as follows: left anterior descending coronary artery, 69.9 +/- 2.5; right coronary artery, 68.0 +/- 5.0; diagonals, 61.0 +/- 4.1; obtuse m arginals, 55.9 +/- 2.2; and posterior descending coronary artery, 53.3 +/- 3.0 (p < 0.001). Graft outflow obstruction resulting from torsion of the graft pedicle or anastomotic stricture was identified in 7 pat ients (2%). After graft revision, flow increased from 9 +/- 4 mL/min t o 69 +/- 13 mL/min (p = 0.023), and velocity rose from 4.6 +/- 1.1 cm/ s to 18.1 +/- 2.4 cm/s (p = 0.009). In conclusion, the system was adeq uate for operative use and allowed identification and correction of te chnical errors.