Related Experiment Videos
The possibility of using celiac trunk branches as coronary artery bypass grafts
P Aarnio1, A Järvinen, A Lehtola
1Department of Thoracic Surgery, Helsinki University Central Hospital, Finland.
Insights
The splenic artery, unlike the gastroepiploic artery, shows promise as a visceral arterial graft for coronary artery bypass grafting, particularly for posterior heart surfaces. Further research is needed to optimize its use in coronary surgery.
Area of Science:
- Cardiovascular Surgery
- Vascular Grafting
- Experimental Surgery
Background:
- The internal mammary artery is a superior graft for coronary artery bypass grafting due to its arterial nature and size compatibility.
- However, the internal mammary artery's reach is limited, preventing its use as a pedicled graft for the posterior heart surface.
Purpose of the Study:
- To evaluate the feasibility of using intra-abdominal visceral arteries, specifically the splenic artery, as grafts for coronary artery bypass grafting.
- To assess the patency and size compatibility of the splenic artery when used for coronary artery anastomosis.
Main Methods:
- Experiments were conducted on eight dogs (9-13.5 kg) to assess splenic artery suitability for coronary artery anastomosis.
- The gastroepiploic artery was initially considered but found to be too small; the splenic artery was then utilized.
Main Results:
- The splenic artery demonstrated good size approximation with coronary arteries (diameter < 1 mm).
- Of the four dogs that survived the study month, splenic artery anastomosis was patent in two, and the graft remained patent in a third despite anastomosis occlusion.
- One dog experienced thrombosis of both the anastomosis and the graft.
Conclusions:
- The splenic artery is a potential candidate for visceral arterial grafting in coronary surgery, especially for reaching posterior cardiac regions.
- While size compatibility is favorable, graft patency requires further investigation and optimization for successful clinical application.
Abstract:
The internal mammary artery has proved to be superior to the saphenous vein for coronary artery bypass grafting, because of its arterial nature and closer approximation in size to the coronary arteries. But the internal mammary artery cannot reach the posterior surface of the heart as a pedicled graft. Two suitable intra-abdominal grafts can reach that surface, viz. the right gastroepiploic artery and the splenic artery. In experiments on eight dogs (weight 9-13.5 kg), the gastroepiploic artery was found to be too small for coronary artery anastomosis, and therefore the splenic artery was used. The size approximation with coronary artery (diameter less than 1 mm) was good. Four dogs survived the month of the study. In two of them the anastomosis was patent, in another the splenic artery was patent despite occlusion of the anastomosis, and in the fourth dog both anastomosis and graft were thrombosed. The possibility of using visceral arterial grafts in coronary surgery is discussed.