text: Flow dynamics of the internal thoracic and radial artery T-graft.
  BACKGROUND:
  Complex use of arterial conduits has resurrected concerns about the adequacy of conduit flow. The T-graft is the extreme example of this trend. Our purpose was to identify the limitation of single source inflow and to compare flow capacity with completion coronary flow.
  METHODS:
  Between February 1999 and November 2001, 372 patients underwent total arterial revascularization with the T-graft alone. Intraoperative flows were recorded for each limb of the T-graft before and after distal anastomoses in 204 patients. Independent predictors of T-graft flow were identified by multivariate analysis.
  RESULTS:
  Free flow for the radial arterial (RA) limb was 161 +/- 81 mL/min, the internal thoracic artery (ITA) limb 137 +/- 57 mL/min (combined 298 +/- 101 mL/min) versus simultaneous limb flow of 226 +/- 84 mL/min giving a flow restriction of 24% +/- 14%. Completion coronary flow was 88 +/- 49 mL/min for the RA, 60 +/- 45 mL/min for the ITA, and 140 +/- 70 mL/min for both limbs simultaneously to give a flow reserve (vs simultaneous free flow) of 160% or 1.6. Independent predictors of completion RA limb flow are RA proximal diameter (p = 0.005), number of anastomoses (p = 0.018), and target stenosis (p = 0.005).
  CONCLUSIONS:
  A flow reserve of 1.6 compares favorably with an ITA flow reserve of 1.8 at 1-month postoperatively and 1.8 for both the ITA T-graft and the ITA/RA T-graft at 1-week postoperatively as reported by others. Proximal RA diameter and competitive coronary flow influence completion T-graft flow. These data quantitate the limitation of single source inflow of the T-graft configuration and support its continued use.
  
entities.text: ['arterial conduits']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T2
entities.text: ['conduit']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T3
entities.text: ['coronary']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T4
entities.text: ['arterial']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T5
entities.text: ['radial arterial (RA) limb']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T6
entities.text: ['internal thoracic artery (ITA) limb']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T7
entities.text: ['coronary']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T9
entities.text: ['limbs']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T10
entities.text: ['RA limb']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T11
entities.text: ['RA']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T12
entities.text: ['ITA']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T13
entities.text: ['ITA']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T14
entities.text: ['RA']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T15
entities.text: ['ITA']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T16
entities.text: ['ITA/RA']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T17
entities.text: ['RA']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T18
entities.text: ['coronary']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T19
entities.text: ['limb']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T8
entities.text: ['radial artery']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T1
entities.text: ['limb']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T22
entities.text: ['internal thoracic']
entities.type: Multi-tissue_structure
entities.entity_id: PMID-15464487_T25