CORRELATION OF MYOCARDIAL-CONTRACTION BAND NECROSIS AND VASCULAR PATENCY - STUDY OF CORONARY-ARTERY BYPASS GRAFT ANASTOMOSES AT BRANCH POINTS

  • 1 January 1977
    • journal article
    • research article
    • Vol. 36  (6) , 642-648
Abstract
Eleven patients who died within 1 wk of operation and in whom saphenous vein bypass graft anastomoses were located at or extended across coronary artery branch points were studied at autopsy. New surgically introduced narrowings of > 75% in 1 branch of the 13 anastomoses studied were more frequent (6 of 8) when the arteriotomy extended into a branch artery than when the arteriotomy ended proximal to the flow divider of the branch point (0-5). Obstruction was most frequently caused by suture compression of the arterial lumen. In 5 of the 6 anastomoses, where 1 branch contained a significant new narrowing and the other did not, a striking difference in the severity of myocardial contraction band necrosis in the distribution of the 2 arteries was found. In each case the severe necrosis was in the distribution of the patent branch artery and the obstructed branch had slight or trivial injury. Myocardium that has the potential for developing contraction band necrosis may not develop it if the reflow phase is suppressed.