Preserved blood flow in the composite right gastroepiploic artery graft during norepinephrine infusion.

Background: We examined the effect of norepinephrine infusion on blood flow in Y-composite right gastroepiploic artery grafts after off-pump coronary artery bypass grafting.

Methods: Enrolled were 28 patients who were scheduled for revascularization with a Y-composite graft (end-to-side anastomosis of the right gastroepiploic artery to the in situ left internal thoracic artery graft). After all planned anastomoses were completed in each patient, blood flow in the right gastroepiploic artery composite graft and the internal thoracic artery graft (proximal and distal to the right gastroepiploic artery graft) was measured before and after continuous norepinephrine infusion.

Results: Blood flow in right gastroepiploic artery (26.4 +/- 15.8 vs 33.8 +/- 18.0 mL/min, p = 0.0004), proximal left internal thoracic artery (47.5 +/- 21.2 vs 61.6 +/- 23.4 mL/min, p < 0.0001), and distal left internal thoracic artery (20.1 +/- 12.1 vs 26.8 +/- 14.6 mL/min, p < 0.0001) grafts increased after norepinephrine infusion. In addition, the proportion of blood flow in right gastroepiploic artery grafts based on the blood flow in proximal left internal thoracic artery grafts was preserved (57.2% +/- 24.7% vs 55.1% +/- 25.6%, p = 0.607).

Conclusions: Blood flow in right gastroepiploic artery composite grafts after off-pump coronary artery bypass grafting was preserved during norepinephrine infusion.