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Intraoperative Doppler-derived measurements of blood flow velocity were used to characterize the hemodynamics in 6 internal mammary artery grafts before and after anastomosis to the left anterior descending artery. Pulsed Doppler spectrum analysis demonstrated a change from a systolic to a predominantly diastolic flow pattern. The presented technique is a valuable aid to differentiate intraoperatively between normal and low flow states in the internal mammary artery. In addition, this study serve as a pilot study to investigate the clinical applicability of Doppler spectrum analysis in the functional assessment of the internal mammary artery in the pre- and postoperative stages of myocardial revascularization.

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A total of 44 patients undergoing isolated aortic valve replacement received either anterograde (20 patients) or retrograde (24 patients), cold St Thomas's Hospital cardioplegia. The patients were similar with respect to age, sex, left ventricular ejection fraction, left ventricular-aortic pressure gradient, cross-clamping time and mean dose of cardioplegia. After surgery, there were no differences in enzyme release, low cardiac output syndrome, rhythm disturbances or clinical outcome between the two groups. Analysis of the postoperative haemodynamic data, however, suggests better preservation of left ventricular contractility with retrograde delivery of cardioplegic solution.

No abstract