Triple Aorto-Coronary Vein Bypass as Treatment for Coronary Insufficiency

Flemma, Robert J.

doi:10.1001/archsurg.1971.01350070108026

Cited by 57 publications

(33 citation statements)

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“…The sequential coronary artery bypass grafting (CABG) technique, as described in early years [1,2], is a technique in which two or more coronary artery anastomoses are made with a single graft, usually the saphenous vein. The distal anastomosis is constructed in an end-to-side fashion, while the proximal anastomosis is constructed in a side-to-side fashion.…”

Section: Introductionmentioning

confidence: 99%

Blood Flow in an Out-of-Plane Aorto-left Coronary Sequential Bypass Graft

Sankaranarayanan

Ghista

Chua

et al. 2009

Computational Cardiovascular Mechanics

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Coronary artery bypass graft (CABG) is a major therapy for ischemic heart disease which if left untreated can progress to failure of the heart. Restenosis, a leading cause of CABG, can be correlated with the geometric configuration and the hemodynamics of the graft. In this chapter we use computational fluid dynamics (CFD) to investigate the hemodynamics in a 3D out-of-plane sequential bypass graft model. Using a finite volume approach, quasi-steady flow simulations are performed at mid-ejection and at mid-diastole. Plots of velocity vectors, wall shear stress (WSS), and spatial WSS gradient (WSSG) distribution are presented in the aorto-left coronary bypass graft domain. Simulation results reveal a more uniform WSS and spatial WSSG distribution in the side-to-side (sequential graft) anastomosis configuration over the end-to-side (multiple graft) anastomosis. Results for the multiple bypass graft model show the peak magnitudes of the spatial WSSG are higher compared to the sequential bypass graft model. These findings suggest that sequential bypass grafting may be preferable over multiple bypass grafting to avoid non-uniformities of WSS. IntroductionThe sequential coronary artery bypass grafting (CABG) technique, as described in early years [1,2], is a technique in which two or more coronary artery anastomoses are made with a single graft, usually the saphenous vein. The distal anastomosis is constructed in an end-to-side fashion, while the proximal anastomosis is constructed in a side-to-side fashion. The advantages of this technique over the single graft technique include fewer anastomoses and higher graft flow [3,4]. Higher patency rates have also been observed through post angiograms in the proximal side-to-side M. Sankaranarayanan (B) Mathematics,

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Section: Introductionmentioning

confidence: 99%

Blood Flow in an Out-of-Plane Aorto-left Coronary Sequential Bypass Graft

Sankaranarayanan

Ghista

Chua

et al. 2009

Computational Cardiovascular Mechanics

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“…Sequential grafting was introduced in the early '70s by Flemma, with the supposed advantage of a decreased total resistance to the graft flow, a minimized impedance mismatch, and a complete revascularization with a shorter vein segment (15). On the other hand, its main drawback is that proximal conduit failure compromises blood flow to a large mass of myocardium (16).…”

Section: Discussionmentioning

confidence: 99%