Improvement in Forward Coronary Blood Flow by Using a Reversed Saphenous Vein with a Competent Valve

Steven J. Phillips, J. Edward Okies, Albert Starr

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

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 < 0.005) and pulsatile flow in 6 veins by 17.7% (p < 0.001). A competent valve in 12 left coronary artery vein grafts increased mean flow by 31.3% (+34 ml/min; p < 0.01) and pulsatile flow in 11 veins by 13.7% (p < 0.001). This study suggests that a portion of reversed saphenous vein containing a competent valve provides greater coronary artery blood flow than veins without valves and may be the conduit of choice for coronary artery revascularization.

Original languageEnglish (US)
Pages (from-to)12-15
Number of pages4
JournalAnnals of Thoracic Surgery
Volume21
Issue number1
DOIs
StatePublished - Jan 1 1976

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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