Roles of Transit-Time Flow Measurement for Coronary Artery Bypass Surgery

Takami, Yoshiyuki; Takagi, Yasushi

doi:10.1055/s-0037-1618575

Cited by 22 publications

(29 citation statements)

References 66 publications

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“…Transit-time flow measurement (TTFM), which utilises ultrasound to measure the flow velocity in blood vessels, is frequently used for the intraoperative assessment of graft quality in patients undergoing CABG 3 – 8 . TTFM is a non-invasive, easy-to-use method for real-time measurement of the graft flow velocity, does not require complex equipment, and provides numerical results 9 , 10 . Moreover, the graft flow velocity measured using this method is reported to be accurate and reproducible 11 , 12 .…”

Section: Introductionmentioning

confidence: 99%

Patient and haemodynamic factors affecting intraoperative graft flow during coronary artery bypass grafting: an observational pilot study

Lee

Kim

et al. 2020

Sci Rep

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Transit-time flow measurement (TTFM) is frequently used to evaluate intraoperative quality control during coronary artery bypass grafting (CABG) and has the ability to assess graft failure intraoperatively. However, perioperative factors affecting TTFM during CABG remain poorly understood. Patients who underwent CABG at a single institution between July 2016 and May 2018 were prospectively evaluated. TTFM and blood viscosity were measured haemodynamically, while mean flow (mL/min), pulsatility index, and diastolic filling were recorded. Arterial blood gas was analysed immediately after left internal mammary artery to left descending artery anastomosis and before sternal closure. Factors associated with TTFM were assessed using multiple linear regression analysis. We evaluated 57 of the 62 patients who underwent CABG during the study period, including 49 who underwent off-pump and 8 who underwent on-pump surgeries. Blood viscosity was not significantly associated with TTFM (p > 0.05). However, TTFM was significantly associated with body mass index, systolic blood pressure, and cardiac index (p < 0.05 each). In conclusion, maintaining the SBP in the perioperative period and maintaining the CI with inotropic support or fluid resuscitation can be important in improving blood flow of graft vessels after surgery. Ischaemic heart disease (IHD) is a global leading cause of death according to the World Health Organization survey from 2000 to 2016 1. The mortality rate of IHD is gradually decreasing in Western countries due to the development of diagnostic and therapeutic techniques for IHD, whereas it is gradually increasing in developing countries because of the rapid increase in westernised lifestyles 2. Coronary artery bypass grafting (CABG) remains an important and a preferred treatment technique despite the development of various interventions for IHD. The early detection of postoperative graft failure after CABG is very important to prevent postoperative complications, such as refractory angina, myocardial infarction, arrhythmias, and even death 3. Transit-time flow measurement (TTFM), which utilises ultrasound to measure the flow velocity in blood vessels, is frequently used for the intraoperative assessment of graft quality in patients undergoing CABG 3-8. TTFM is a non-invasive, easy-to-use method for real-time measurement of the graft flow velocity, does not require complex equipment, and provides numerical results 9,10. Moreover, the graft flow velocity measured using this method is reported to be accurate and reproducible 11,12. Blood viscosity, an indicator of the stickiness of blood, can be measured as the degree of blood resistance to flow 13. The most important factors influencing blood viscosity are haematocrit, red blood cell deformability, red blood cell aggregation, and plasma viscosity 14,15 , with haematocrit being the most important factor 14. Plasma viscosity is a function of the water content and macromolecular components, including the types and concentrations of plasma proteins 14,16. Blood visc...

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Section: Introductionmentioning

confidence: 99%

Patient and haemodynamic factors affecting intraoperative graft flow during coronary artery bypass grafting: an observational pilot study

Lee

Kim

et al. 2020

Sci Rep

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“…However, owing to stenosis or occlusion of LIMA or harvested damage, surgeons have to choose other conduit materials to revascularize the LAD. Transit-time flow measurement (TTFM) has been increasingly applied to judge the quality of anastomosis and blood flow during CABG, because TTFM is less invasive, more reproducible, and less time consuming [4]. A previous study demonstrated that studies on TTFM should consider conduit materials and different coronary territories, while few studies on the comparison of different conduit materials used for LAD in terms of TTFM parameters have been reported [5].…”

Section: Introductionmentioning

confidence: 99%

Use of the right internal mammary artery and the great saphenous vein for left anterior descending artery revascularization in patients whose left internal mammal artery cannot be used: a study based on transit-time flow measurement

Zhang

Zhao

Chen

et al. 2020

J Cardiothorac Surg

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Background: Owing to the high patency, the use of the left internal mammary artery (LIMA) for left anterior descending artery (LAD) grafting has been a cornerstone of coronary artery bypass grafting surgery (CABG). However, for some patients whose LIMA cannot be used, surgeons have to choose other conduit materials to revascularize the LAD. The purpose of this study was to explore the differences in different conduit materials used for LAD in terms of parameters measured by transit-time flow measurement (TTFM) and the early graft patency detected by computed tomography angiography. Methods: We retrospectively collected the data of 410 patients who underwent isolated primary OPCAB with intraoperative TTFM data. According to the strategy of the LAD revascularization, 410 patients were assigned to three groups: a left internal mammal artery (LIMA) group (n = 333), a right IMA (RIMA) group (n = 34) and a great saphenous vein (SVG) group (n = 43). The baseline and perioperative blood parameters were compared for the three groups, as well as the early graft patency rates.

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“…Transit-time flow measurement (TTFM), which utilizes ultrasound to measure flow velocity in blood vessels, is frequently used for intraoperative assessment of graft quality in patients undergoing coronary artery bypass graft (CABG) surgery [3][4][5][6][7][8]. TTFM is a noninvasive, easy-to-use method of measuring graft flow velocity in real time, does not require complex equipment, and provides numerical results [9,10].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Whole Blood Viscosity on Intraoperative Graft Flow during Coronary Artery Bypass Graft Surgery: An Observational Pilot Study

Lee¹,

Jo²,

Kim³

et al. 2019

Preprint

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Running titleEffect of blood viscosity on intraoperative graft flow Preprints (www.preprints.org) | NOT PEER-REVIEWED | Posted: AbstractBackground: Transit-time flow measurement (TTFM) is frequently used to evaluate intraoperative quality control during coronary artery bypass grafting (CABG). Although TTFM has the ability to assess graft failure intraoperatively, the perioperative factors affecting TTFM during CABG surgery remain poorly understood. Methods:Patients who underwent CABG surgery at a single institution between July 2016 and May 2018 were prospectively evaluated. Patients' demographic characteristics, previous medical history, Euroscore, the results of preoperative blood tests, and intraoperative data were recorded. TTFM and blood viscosity were measured hemodynamically, and mean flow (mL/min) and pulsatility index (PI) were recorded. Arterial blood gas was analyzed immediately after anastomosis of the left internal mammary artery (LIMA) to the left descending artery (LAD) and before sternal closure. Factors associated with TTFM were assessed by multiple linear regression analysis. Results:Of the 62 patients who underwent CABG surgery during the study period, 57 were evaluated, including 49 who underwent off-pump and eight who underwent on-pump surgery. Blood viscosity was not significantly associated with TTFM (p > 0.05). However, TTFM was significantly associated with body mass index (BMI), systolic blood pressure, and cardiac index (p < 0.05 each).Conclusions: Blood viscosity was not significantly associated with intraoperative graft flow. Blood flow of graft vessels, however, was significantly associated with BMI, systolic blood pressure, and cardiac index. KeywordsBlood viscosity, Transit-time flow measurement, Coronary artery bypass surgery Preprints (www.preprints.org) | NOT PEER-REVIEWED | Posted:

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Roles of Transit-Time Flow Measurement for Coronary Artery Bypass Surgery

Cited by 22 publications

References 66 publications

Patient and haemodynamic factors affecting intraoperative graft flow during coronary artery bypass grafting: an observational pilot study

Patient and haemodynamic factors affecting intraoperative graft flow during coronary artery bypass grafting: an observational pilot study

Use of the right internal mammary artery and the great saphenous vein for left anterior descending artery revascularization in patients whose left internal mammal artery cannot be used: a study based on transit-time flow measurement

The Effect of Whole Blood Viscosity on Intraoperative Graft Flow during Coronary Artery Bypass Graft Surgery: An Observational Pilot Study

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