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Effect of carbon dioxide insufflation on free internal thoracic artery flows: is it a vasodilator?

Mehmet Ozkan1, Ismail Koramaz, A Tulga Ulus

  • 1Department of Cardiovascular Surgery, Ozel Karadeniz Hospital, Trabzon, Turkey.

The Journal of Thoracic and Cardiovascular Surgery
|September 9, 2004
PubMed

Insights

Carbon dioxide insufflation significantly increases initial free flow in internal thoracic arteries during coronary artery bypass grafting. This technique enhances arterial flow, potentially avoiding spasm and the need for vasodilators.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Biology

Background:

  • Internal thoracic artery (ITA) flow is critical for coronary artery bypass grafting (CABG) success.
  • Arterial spasm and reduced early flow can compromise ITA graft function.
  • Evaluating methods to optimize ITA flow is essential for improving CABG outcomes.

Purpose of the Study:

  • To assess the impact of carbon dioxide (CO2) insufflation on free internal thoracic artery flows.
  • To compare ITA flow in CO2-insufflated grafts versus conventionally harvested grafts.

Main Methods:

  • A study involving 56 patients undergoing CABG, with ITA grafted to the left anterior descending artery.
  • Group 1 (n=26): ITA harvested as a pedicled graft.
  • Group 2 (n=30): ITA harvested using CO2 insufflation technique; initial free flows measured in both groups.

Main Results:

  • Initial free flow was significantly higher in the CO2-insufflated ITA group (60 mL/min) compared to the pedicled group (28 mL/min; P < .05).
  • Second free flow measurements showed higher, though not statistically significant, flow in the CO2 group (68 mL/min vs 53 mL/min; P = .53).

Conclusions:

  • CO2 insufflation is an effective method for increasing ITA blood flow.
  • This technique appears safe, simple, and reliable for optimizing ITA grafts in CABG.
  • CO2 insufflation may prevent arterial spasm and improve early graft flow without vasodilators.
Abstract

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