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Eur J Cardiothorac Surg 2006;29:948-951
© 2006 Elsevier Science NL

Sympathetic stimulation increases the blood flow through the in situ right gastroepiploic artery graft after off-pump coronary artery bypass graft surgery

^a Department of Anesthesiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong Chongno-gu, Seoul 110-744, Republic of Korea
^b Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

Received 21 November 2005; received in revised form 27 February 2006; accepted 10 March 2006.

^_* Corresponding author. Tel.: +82 2 2072 2818; fax: +82 2 747 5639. (Email: bahkjh{at}snu.ac.kr).

Objective: The right gastroepiploic artery is gaining popularity as an in situ arterial graft for coronary artery bypass surgery. Unlike the internal thoracic artery, the right gastroepiploic artery is a visceral artery and has a vasoconstrictive tendency in response to sympathetic stimulation. We hypothesized that blood flow through the in situ right gastroepiploic arterial graft might be compromised after sympathetic stimulation. Methods: Thirty patients scheduled for off-pump coronary artery bypass surgery using the left internal thoracic artery and the right gastroepiploic artery as in situ arterial grafts were enrolled. Blood flow through both arteries was measured by transit time flow before (T1), during (T2), and after noradrenalinee infusion (T3). Results: After sympathetic stimulation, blood flow of both the right gastroepiploic artery (30.1 ± 13.9 mL/min at T1 vs 36.2 ± 17.5 mL/min at T2; P = 0.001) and left internal thoracic artery grafts (37.3 ± 19.1 mL/min at T1 vs 41.8 ± 18.2 mL/min at T2; P = 0.01) was increased significantly. However, blood flow in proportion to cardiac output increased only in the right gastroepiploic artery graft (P = 0.01). Conclusions: Sympathetic stimulation increases, rather than compromises, blood flow through the right gastroepiploic artery graft after coronary revascularization.

Key Words: Right gastroepiploic artery • Sympathetic stimulation • Blood flow • Coronary artery bypass • Off-pump