Coronary artery bypass grafting with composite grafts: comparison of blood flow to the left coronary artery with the conventional technique Revascularização cirúrgica do miocárdio com enxerto composto de artérias torácica interna esquerda e radial: comparação do fluxo sangüíneo para artéria coronária esquerda com a técnica

AbstractBackground: Composite grafting techniques for coronaryartery bypass grafts (CABG) have been widely used. However,it remains unclear whether this technique provides similarblood flow to the left coronary artery when compared to theconventional alternative. We sought to compare the total bloodflow to the left coronary branches that are revascularizedwith left internal thoracic (LITA) and radial artery (RA) graftsusing composite and non-composite techniques. Method : A total of 42 patients were randomly assigned tothree groups according to the CABG technique to be used:Group A or composite LITA-RA in a Y format (n=14); Group Bor modified composite LITA-RA [intercoronary graft with RAand LITA to RA at the level of the left anterior descendingartery (LAD), n=14)]; and Group C or pedicled LITA to theLAD and aorto-coronary RA (n=14). The patients weresubmitted to postoperative blow flow velocity analysis usinga 0.014 inch 12 MHz Doppler flowire. Coronary flow reserve(CFR) was calculated by determining the average hyperemicpeak velocity (APV) after an injection of adenosine.