Relation of intraoperative flow measurement with postoperative quantitative angiographic assessment of coronary artery bypass grafting

Takami, Yoshiyuki; Ina, Hiroshi

doi:10.1016/s0003-4975(01)02933-2

Cited by 55 publications

(34 citation statements)

References 12 publications

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“…TTF measurements are fast, easy, and reproducible. The results are also predictive of graft occlusion at short-term angiographic follow-up, and are less affected by artefacts than are other graft assessment techniques (8,9). However, the TTF method is not perfect as it is possible to have a patent anastomosis with a low graft TTF or, conversely, a partially compromised anastomosis with a high graft TTF.…”

Section: Introductionmentioning

confidence: 99%

Intra-operative Graft Blood Flow Measurements for Composite and Sequential Coronary Artery Bypass Grafting

et al. 2014

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Objectives Intraoperative assessment of coronary artery bypass grafts (CABG) anastomotic quality can be performed using transit-time flowmetry (TTF). The aim of this study was to compare on- versus off-pump coronary graft TTF and early postoperative outcomes. Materials and methods Between January 2009 and January 2010, 521 distal graft flows were assessed using TTF measurements in 253 consecutive patients undergoing primary isolated CABG surgery. Data were analyzed using multilevel models accounting for clustering among surgeons and grafts performed in the same patient. Results Mean age was 66 ± 10 years and 22% were female (n = 55) with 34% diabetics (n = 86) and 40% pre-operative myocardial infarction (MI) (n = 101). The surgeries were performed off-pump in 67% (n = 170) with sequential vein grafts in 57% (n = 144) of patients. Off-pump patients had higher pre-operative left ventricular ejection fractions (LVEF), fewer urgent surgeries, fewer distal anastomoses, and fewer sequential vein grafts (all p<0.001). Intra-operative coronary graft TTF measurements were lower in sequential vein grafts performed off-pump versus on-pump. More patients in the on-pump group needed milrinone or dobutamine 24-48 h postoperatively (p = 0.005). Independent predictors of lower TTF included female gender and off-pump surgery, whereas predictors of better TTF were pre-operative MI, larger coronary diameter at the site of the distal anastomosis, and sequential vein grafting. Conclusions Lower intra-operative TTF measurements were found in sequential vein grafts in offpump CABG. However, off-pump patients experienced similar short-term outcomes compared to on-pump patients.

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Section: Introductionmentioning

confidence: 99%

Intra-operative Graft Blood Flow Measurements for Composite and Sequential Coronary Artery Bypass Grafting

et al. 2014

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“…19,20 However, the IFI system is dependent on the surgeon's skill and the method for injecting ICG to assess the quality of grafts. It is sometimes diffi cult to detect anastomosis of coronary arteries behind the heart (e.g., right coronary distal branches or left circumfl ex distal branches) using the IFI system.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the waveforms of transit-time flowmetry and intraoperative fluorescence imaging for assessing coronary artery bypass graft patency

Hatada

Okamura

Kaneko

et al. 2011

Gen Thorac Cardiovasc Surg

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“…Flow pattern is predominantly diastolic in all grafts but is more marked in the left coronary system; because of a smaller right ventricular transmyocardial pressure gradient, there is a comparatively greater systolic flow component in grafts to the right coronary system [2]. A number of studies have reported the usefulness and efficacy of TTFM [10,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Takami et al [12,13] described the usefulness of TTFM in the detection of intraoperative graft failure of several types of grafts.…”

Section: Ultrasound Technologymentioning

confidence: 99%

Intraoperative graft assessment during coronary artery bypass surgery

Fukui

2015

Gen Thorac Cardiovasc Surg

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Coronary artery bypass grafting (CABG) is an established revascularization method for treating multivessel coronary artery disease. The goal of CABG is to achieve complete revascularization with a durable, patent graft without reintervention. However, early graft failure, including that associated with technical errors, has been reported. This makes intraoperative verification of graft patency one of the most important ways in which surgeons can reduce the rate of early graft failure. Conventional angiography is considered the gold standard for graft assessment. However, because it is invasive and inconvenient, several alternatives to intraoperative graft assessment have become available that help reduce early graft failure by allowing revision of the anastomosis intraoperatively. The aim of this article is to review the advantages and disadvantages of several intraoperative graft assessment methods for CABG.

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Relation of intraoperative flow measurement with postoperative quantitative angiographic assessment of coronary artery bypass grafting

Cited by 55 publications

References 12 publications

Intra-operative Graft Blood Flow Measurements for Composite and Sequential Coronary Artery Bypass Grafting

Intra-operative Graft Blood Flow Measurements for Composite and Sequential Coronary Artery Bypass Grafting

Comparison of the waveforms of transit-time flowmetry and intraoperative fluorescence imaging for assessing coronary artery bypass graft patency

Intraoperative graft assessment during coronary artery bypass surgery

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