Improvement in forward coronary blood flow by using a reversed saphenous vein with a competent valve

S. J. Phillips, J. E. Okies, Albert Starr

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Abstract

Reversed segments of saphenous vein have been the grafts of choice for aortocoronary bypass (ACB). Internal mammary arteries and free radial autografts have recently been shown to have a higher patency rate, but flow is usually lower. Normally forward coronary blood flow ceases and retrograde flow occurs during cardiac systole. Prevention of retrograde flow with a rapidly acting valve proximal to the coronary artery anastomosis should improve forward coronary blood flow. Thirty nine reversed saphenous veins containing a competent valve were implanted in 32 patients undergoing ACB. After accurate zero flow was determined and a resting state achieved, mean (22 veins) and pulsatile (17 veins) flows were measured distal to the valve with the valve competent and temporarily incompetent. A competent valve in 10 right coronary artery vein grafts increased mean flow by 29.7% (+41 ml/min; p

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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