ABSTRACTS Heart, Lung and Circulation Abstracts 797 2011;20:778–806 Scientific sessions abstract presentations specific question of the second best conduit. In this study we sought to determine whether there was a difference in clinical outcomes in studies that compared grafting the radial artery and the saphenous vein to the second best target. Methods: We have performed a meta-analysis of tri- als comparing the outcomes of patients receiving a radial artery (RA) or saphenous vein (SV) graft to the best target after grafting the LIMA to LAD. We assessed early (<1y) and late survival (>1y) as the primary outcome. Results: Eight trials (three randomised, five obser- vational) were identified and compared 2980 patients with LIMA/radial artery grafting with 6158 patients with LIMA/SV grafting. The mean follow-up of trials included in the late follow-up analysis ranged from 5.7 to 7 years. There was no significant difference in mortality early period (1.11% vs 1.67%, RR 0.85, 95% confidence interval [CI] 0.53–1.38, p = 0.52). Mortality was significantly lower in RA group for the late follow-up period (13.55% vs 28.46%, RR 0.63, CI 0.45–0.87, p = 0.005). Conclusion: The results of this meta-analysis suggest that the RA may have a survival benefit over the SV in the late post-operative period when grafted to the best target after LIMA to LAD. doi:10.1016/j.hlc.2011.08.049 2011 Poster Presentations/Panel 11 The Influence of Systemic Sympathetic Activity on the Regulation of Cerebral Blood Flow and Cerebrovascular CO 2 Reactivity Sean D. Galvin 1,3,∗ , Kate N. Thomas 1,2 , Philip N. Ainslie 4 , Samuel J.E. Lucas 1,2 1 Department of Physiology, University of Otago, Dunedin, New Zealand 2 School of Physical Education, University of Otago, Dunedin, New Zealand 3 Department of Cardiothoracic Surgery, University of Otago, Dunedin, New Zealand 4 Department of Health and Human Kinetics, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, British Columbia, Canada Introduction: Regulation of cerebral blood flow (CBF) is complex and is influenced by several factors includ- ing changes in arterial PCO 2 and arterial blood pressure (MABP). Sympathetic nerve activity (SNA) is known to be an important regulator of MABP via its effect on periph- eral vascular resistance and cardiac output. Therefore, CBF may also be effected directly or indirectly by changes in cardiac output and SNA. We examined the effect of age on the influence of systemic sympathetic activity on regu- lating cerebral perfusion at rest and during exercise. Methods: Eight younger (aged: 26 ± 5 y) and eight older (aged: 56 ± 3 y) participants were tested at supine rest and during a 10-min exercise test (at 50% HR) before (control) and 90 min following the administration of selective  1 - blockade (Prazosin; 1 mg/20 kg body weight). Continuous measures of middle cerebral artery blood flow veloc- ity (MCAv, Transcranial Doppler); MABP (intra-arterial and/or Finometer); heart rate (HR, ECG) and end-tidal PCO 2 (P ET CO 2 ) were obtained during steady-state eup- capnia (room air) and hypercapnia (7% CO 2 ; 93% O 2 ) conditions at rest and during exercise. Results: At supine rest,  1 -adrenoreceptor blockade decreased MAP by a comparable extent in both younger (82–68 mmHg) and older (97–80 mmHg) participants. In the control condition, exercise-induced MABP increases were similar for both groups (17 vs. 24 mmHg; P = 0.45). Following blockade, exercise-induced increases were abolished in the young (5 mmHg; P = 0.24 vs. rest) yet remained in the old (15 mmHg; P < 0.01 vs. rest). Following blockade, MCAv was reduced (P < 0.01) for both young and old at rest [76–65 cm s -1 (young) and 60–48 cm s -1 (old)]. Exercise-induced increases in MCAv were abolished in the young following blockade (18 vs. 1 cm s -1 ; interaction effect: P < 0.01), whilst the older group’s response was unaffected (5 vs. 2 cm s -1 ; inter- action effect: P = 0.66). Unexpectedly, CBF responsiveness to hypercapnia was reduced in the young during exercise (3.1–2.2 cm s -1 mm Hg -1 ), whilst the older group showed the expected increase (2.3–3.0 cm s -1 mmHg -1 ). Following blockade, hypercapnia CBF responsiveness increased for both groups at rest and during exercise (P < 0.05). Conclusions: The reliance on  1 sympathetically driven vasoconstriction during exercise is critical in the young but seems to be a redundant mechanism in order to main- tain MABP with advancing age. Regardless of the pathway, exercise-induced elevations in MABP with ageing would seem beneficial in the regulation of MCAv. Furthermore, these data provide evidence for sympathetically mediated constraint on CBF-CO 2 responsiveness during rest and exercise. doi:10.1016/j.hlc.2011.08.050 2011 Poster Presentations/Panel 12 Graphical Statistical Process Control Tools in Cardiac Surgery Bruce Garlick ∗ , Michael Gardner, Peter Tesar, Terry Mau, Homayoun Jalali, Chris Smith, Trevor Fayers, Peter Lavercombe, Ian Smith, John Rivers, Russell Brighouse St Andrew’s Medical Institute, St. Andrew’s War Memorial Hospital, Brisbane, Australia Introduction: Graphical Statistical Process Control (SPC) tools have been shown to promptly identify vari- ations in clinical outcome. The application of these techniques has been used in the cardiac surgical mor- bidity and mortality (M&M) review process at the St Andrews War Memorial Hospital (SAWMH). Performance measures and benchmarks have been developed and evaluated using a combination of risk-adjusted Cumula- tive Sum (CUSUM) and Exponentially Weighted Moving Average (EWMA) charts and Funnel plots. In late August 2010, a chart monitoring a composite mea- sure of blood product use and reoperation for bleeding (BP/Reop) signalled that a shift in performance had been