The application of intraoperative transit time flow measurement to accurately assess anastomotic quality in sequential vein grafting

Yu, Yang; Fan, Zhanming; Gao, Mei; Li, Haitao; Li, Jingxing; Song, Wei; Huang, Xin-sheng; Gu, Chengxiong

doi:10.1093/icvts/ivt398

Cited by 10 publications

(8 citation statements)

References 22 publications

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“…Detailed surgical procedures of OPCABG have been described previously. 8 The posterior descending artery (PDA) is preferred for revascularization when the RCA is the target vessel in CABG. All patients were operated on by the same surgeon and the decision to perform CE was mainly based on the results of the last coronary angiogram before the operation and intraoperative findings of the target coronary artery.…”

Section: Methodsmentioning

confidence: 99%

Short-term outcomes of preoperative intra-aortic balloon pump use in patients undergoing adjunctive coronary endarterectomy: a retrospective observational study

Wang

Hao

et al. 2018

Perfusion

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Patients in the IABP group had a significantly lower mean preoperative ejection fraction and a significantly higher mean EuroSCORE (both <0.05). The incidence of inferior myocardial infarction (MI) was significantly lower in the IABP group than in the control group (3.6% vs 15.6%, RR = 0.23, 95% CI 0.05-1.00, p=0.03). Hospital mortality was similar in the two groups (3.6% vs 4.7%, RR= 0.76, 95% CI 0.13-4.40, p=0.76). There were no significant differences between the two groups with respect to the rates of prolonged ventilation, low cardiac output syndrome, renal failure requiring dialysis, re-operation for bleeding or IABP-related complications. Preoperative IABP may be a protective factor of inferior MI (HR = 0.031, 95% CI 0.004-0.211, p<0.001) Conclusions: The preoperative use of IABP could reduce the incidence of postoperative MI in patients undergoing CABG with CE and seemed to shift high-risk patients into a lower-risk category.

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Section: Methodsmentioning

confidence: 99%

Short-term outcomes of preoperative intra-aortic balloon pump use in patients undergoing adjunctive coronary endarterectomy: a retrospective observational study

Wang

Hao

et al. 2018

Perfusion

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“…Detailed surgical procedures of OPCAB have been described in our previous study. 14 The left internal mammary artery (LIMA) and the saphenous vein were routinely harvested. The saphenous veins were mainly harvested from the calf by a conventional open technique by the same surgeon.…”

Section: Operation Techniquementioning

confidence: 99%

Distal anastomosis support for bypass grafting with coronary endarterectomy for the severe diseased posterior descending artery

Wang

Liu

et al. 2021

Perfusion

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Background: The posterior descending artery is the most common vessel chosen for an endarterectomy, while endarterectomy to the posterior descending artery is associated with decreased graft patency. The purpose of this study was to describe a distal anastomosis support (DAS) technique and retrospectively investigate the effect of DAS on the mid-term graft patency. Methods: Between January 2016 and December 2018, 200 patients with a PDA severe lesion who underwent off-pump coronary artery bypass (OPCAB) with CE (OPCAB + CE group, n = 95) and OPCAB + CE with DAS for anastomosis of PDA grafted by saphenous vein (SVG) (OPCAB + CE + DAS group, n = 105) were evaluated retrospectively. All patients came back to follow-up visit 6th, 12th, 24th, and 36th postoperative month. The primary endpoint is the graft failure (FitzGibbon B or O) of SVG-PDA on the follow-up CTA or CAG. Results: There was no significant difference in perioperative outcomes. We found significantly improved cumulative graft patency in OPCAB + CE + DAS group at 36 months after operation (84.6% vs 76.5%, p = 0.02). In multivariate Cox regression analysis, plaque length larger than 2 cm (hazard ratio [HR], 13.108, 95% confidence interval [CI], 2.842–60.457, p = 0.001), and peak TNI ⩾70× ULN within 48 hours of surgery (HR, 3.778, 95% CI, 1.453–9.823, p = 0.006) were independent predictors of graft failure, whereas PDA diameter greater than 1.5 mm (HR, 0.231, 95% CI, 0.081–0.654, p = 0.006), and DAS use (HR, 0.336, 95% CI, 0.139–0.812, p = 0.015) were significant protective factors. Conclusions: Concomitant DAS conferred superior mid-term patency of SVG-PDA. Adding the DAS procedure to OPCAB + CE may be a promising surgical option for patients with a PDA severe lesion, especially when PDA diameter less than 1.5 mm and plaque length greater than 2 cm.

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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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The application of intraoperative transit time flow measurement to accurately assess anastomotic quality in sequential vein grafting

Cited by 10 publications

References 22 publications

Short-term outcomes of preoperative intra-aortic balloon pump use in patients undergoing adjunctive coronary endarterectomy: a retrospective observational study

Short-term outcomes of preoperative intra-aortic balloon pump use in patients undergoing adjunctive coronary endarterectomy: a retrospective observational study

Distal anastomosis support for bypass grafting with coronary endarterectomy for the severe diseased posterior descending artery

Intraoperative graft assessment during coronary artery bypass surgery

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