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Related Concept Videos

Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...

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Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
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Competitive flow in coronary bypass surgery: is it a problem?

David Glineur1, Claude Hanet

  • 1Department of Cardiovascular Medicine and Surgery, Cliniques Universitaire St Luc, University of Louvain Medical School, Brussels, Belgium. david.glineur@uclouvain.be

Current Opinion in Cardiology
|October 19, 2012
PubMed
Summary

Competition flow can cause arterial graft occlusion. Choosing the right graft (like internal thoracic artery) and configuration, guided by fractional flow reserve, improves graft survival.

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Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Biology
  • Surgical Innovation

Background:

  • Competition flow is a frequent complication in arterial grafting, potentially leading to graft failure.
  • Understanding the factors influencing competition flow is crucial for optimizing surgical outcomes.

Purpose of the Study:

  • To review the impact of competition flow on different arterial conduits used in coronary artery bypass grafting.
  • To evaluate the role of graft choice, configuration, and assessment tools in mitigating competition flow and improving graft patency.

Main Methods:

  • Review of current literature on arterial grafting and competition flow.
  • Analysis of the characteristics of various arterial conduits (internal thoracic artery, radial artery, right gastroepiploic artery, saphenous vein graft) in relation to flow dynamics.
  • Discussion of graft configuration strategies and the utility of fractional flow reserve (FFR).

Main Results:

  • Internal thoracic arteries demonstrate superior resistance to competition flow due to their endothelial function.
  • Radial and right gastroepiploic arteries are more susceptible to spasm and occlusion from competition flow.
  • Saphenous vein grafts are less affected by competition flow due to their properties and implantation site.
  • Graft configuration, particularly composite grafting, requires careful consideration based on target lesion severity.

Conclusions:

  • Competition flow significantly impacts arterial graft functionality and longevity.
  • Strategic graft selection and configuration are essential to prevent graft attrition.
  • Utilizing tools like fractional flow reserve can enhance decision-making and improve arterial grafting outcomes.