Functional comparison of coronary bypass grafts of the saphenous vein and internal mammary artery.

The magnitude and distribution of myocardial blood flow through a saphenous vein (SV) bypass graft and an internal mammary artery (IMA) graft (diameter greater than or equal to 2 mm) into the same left anterior descending coronary artery (LAD) (diameter congruent to 1.5 mm) were determined at rest, with atrial pacing, and with elevated left ventricular end-diastolic pressure (LVEDP) in 18 dogs. Blood flows through the native LAD, SV, and IMA grafts were similar in the resting heart. With atrial pacing (heart rate = 150% of control), flow in both the SV and IMA grafts increased but the difference was not significant. With elevated LVEDP (20 mm Hg) produced by transfusion, flow in both SV and IMA grafts increased, but, again, these increases were not significantly different. The SV and IMA bypass grafts have similar flow rates at rest and during increased functional demand, provided the grafts are larger than the vessels into which they are placed.