Intraoperative Transit-Time Flow Measurement is Not Altered in Venous Bypass Grafts Covered by the eSVS Mesh

Emery, Robert W.; Solien, Eric

doi:10.1097/imi.0b013e31828e5d1e

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…The comparatively low diastolic filling measured in our patient (54% and 55%) is due to the fact that the measurements were taken on a vein graft to the right coronary artery, which contrasts with the higher diastolic filling (971%) found in the experimental measurements performed on a vein graft to the left anterior descending coronary artery in the cited porcine article. 6…”

Section: Discussionmentioning

confidence: 99%

External Saphenous Vein Support Mesh Does Not Interfere with Transit-Time Flow Measurement on Venous Coronary Bypass Conduit: Clinical Confirmation

Mootoosamy

Jolou

Myers

et al. 2016

Innovations�(Phila)

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A 65-year-old patient underwent double coronary artery bypass grafting using the left internal thoracic artery on the left anterior descending coronary artery and nitinol alloy mesh [external Saphenous Vein Support (eSVS)]–covered saphenous vein graft to the right posterior descending coronary artery. Transit-time flow measurements (TTFMs) were obtained on meshed and bare parts of the vein graft. There was no difference in TTFM parameters (flow, pulsatility index, and diastolic fraction values) obtained from the eSVS mesh-covered and the uncovered parts of the venous graft. This observation confirms that eSVS mesh does not interfere with TTFM on venous coronary bypass conduits.

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Section: Discussionmentioning

confidence: 99%

External Saphenous Vein Support Mesh Does Not Interfere with Transit-Time Flow Measurement on Venous Coronary Bypass Conduit: Clinical Confirmation

Mootoosamy

Jolou

Myers

et al. 2016

Innovations�(Phila)

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“…Une et al associated a TTFM flow < 31 ml/min with significantly worse one-year SVG patency than higher flows in CABG [ 18 ]. The adequacy of intraoperative TTFM in meshed SVGs was published by Emery et al [ 19 ]. However, our conflicting association of a low PI and graft occlusion questions its predictive value.…”

Section: Discussionmentioning

confidence: 99%

One-year patency control and risk analysis of eSVS®-mesh-supported coronary saphenous vein grafts

Inderbitzin

Bremerich

Matt

et al. 2015

J Cardiothorac Surg

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BackgroundThe eSVS® external venous nitinol mesh (Kips Bay Medical, Minneapolis, USA) was designed to improve long-term patency of coronary saphenous vein grafts (SVG) by preventing pressure-induced wall stress and reactive neo-intimal hyperplasia. We present one-year-patency rates of meshed SVGs assessed by coronary computed tomographic angiography (cCTA).Patients and MethodsData from consecutive patients receiving an eSVS® meshed coronary bypass SVG from 06/2010 to 06/2011 were prospectively collected and analysed post-hoc. Patient characteristics, coronary artery disease, SVG quality, surgery (including number of anastomoses and transit time flow-measurement: TTFM), postoperative course and graft patency by cCTA were recorded. Potential risk factors for meshed graft occlusion were evaluated.Results22 patients received an eSVS® mesh (18 isolated CABG, 4 combined with aortic valve replacement). Three patients died prior to the one-year follow-up and were excluded. All 19 surviving patients (mean age 70.4 ± 9.5 years, 3 female) completed a cCTA of all grafts at 12 ± 0.1 months after surgery including 21 meshed SVGs (33 distal anastomoses), 7 unmeshed SVGs (13 distal anastomoses) and 22 arterial grafts (30 distal anastomoses).Mesh application was safe with patent grafts (by intraoperative TTFM) and perioperative course uneventful in all patients. The average graft/anastomosis number per patient was 2.6 ± 0.5/3.7 ± 0.8. Patency was unrestricted in all arterial and unmeshed SVGs (cCTA). Meshed SVG patency was 85 % (n = 28/33) for distal anastomoses and 76 % (n = 16/21) among meshed SVGs. Four SVGs with single distal anastomosis to the right coronary were completely occluded. One sequential graft to the left coronary was occluded between proximal and first distal anastomosis (see Fig. 1). Patency was independent of target site, coronary run-off, SVG quality and sequential distal grafting. All patients were asymptomatic.ConclusionsThe overall one-year patency rate of eSVS® meshed SVGs/anastomoses was 76 %/85 %. Surgical implantation is safe independently of target site, run-off, vein quality and sequential distal anastomoses. However, graft patency of meshed veins (76 %) was inferior to non-meshed (100 %) or arterial grafts (100 %). Thus our mid-term data do not sustain the concept of improving vein graft patency by external reinforcing with the eSVS® mesh. Further long-term follow-up is warranted.

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Exostents de injertos de vena safena: revisión bibliográfica y metaanálisis de efectividad

Martín Gutiérrez,

Maiorano,

Castillo Pardo

et al. 2024

Cirugía Cardiovascular

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Intraoperative Transit-Time Flow Measurement is Not Altered in Venous Bypass Grafts Covered by the eSVS Mesh

Cited by 4 publications

References 14 publications

External Saphenous Vein Support Mesh Does Not Interfere with Transit-Time Flow Measurement on Venous Coronary Bypass Conduit: Clinical Confirmation

External Saphenous Vein Support Mesh Does Not Interfere with Transit-Time Flow Measurement on Venous Coronary Bypass Conduit: Clinical Confirmation

One-year patency control and risk analysis of eSVS®-mesh-supported coronary saphenous vein grafts

Exostents de injertos de vena safena: revisión bibliográfica y metaanálisis de efectividad

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