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Eur J Cardiothorac Surg 2001;20:1077
© 2001 Elsevier Science NL

Letter to the Editor

Reply to D'Ancona et al.

Department of Cardiovascular Surgery, Tokyo Saiseikai Central Hospital 1-4-17 Mita, Minato-Ku, Tokyo 108-0073, Japan

Received 19 July 2001; accepted 20 July 2001.

Tel.: +81-3-3451-8211; fax: +81-3-3457-7949
e-mail: hero.takashi{at}nifty.ne.jp

We appreciate the comments on our article [1], which were raised by Dr D'Ancona and co-workers. We agree with them in the point that the interpretation of mean flow values together with transit time flow curves and PI values may improve the ability to detect bypass failure. In fact, when the mean flow rate of a bypass graft is low, its flow curve indicating the diastolic dominance, as well as PI values included between 1 and 5, may help us to regard the graft as having no problems. In the study of our series, however, two of seven internal thoracic artery (ITA) grafts with more than 75% stenosis at their anastomosed sites showed the mean flow rate of higher than 80 ml/min, and three of eleven ITA grafts which showed a string sign on the pre-discharge coronary angiography, had the mean flow rate of higher than 100 ml/min. We consider the existence of the process, in which the anastomosed site is slowly narrowed after closure of the sternum or in which the caliber of ITA grafts is gradually adapted to the appropriate size according to the myocardial oxygen demands after surgery.

In conclusion, the bypass flow was affected by so many factors that stenosed or narrowed grafts could not accurately be predicted by the intraoperative measurement of the bypass flow rate alone.

References

1. Hirotani T., Kameda T., Shirota S., Nakao Y. An evaluation of the intraoperative transit time measurements of coronary bypass flow. Eur J Cardio-thorac Surg 2001;19:848-852.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hirotani, T. Search for Related Content PubMed Articles by Hirotani, T. Related Collections Coronary disease