Transit time flow measurement in on-pump and off-pump coronary artery surgery

Schmitz, Christoph; Ashraf, Obaid; Schiller, Wolfgang; Preusse, C. J.; Esmailzadeh, Bahman; Likungu, J.; Fimmers, Rolf; Welz, Armin

doi:10.1016/s0022-5223(03)00018-7

Cited by 37 publications

(35 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The values of P w (mean P w = 38.3 ± 5.5 mmHg), Q LADg (mean Q LADg = 31.2 ± 10.1 mL/min), and Q LCXg (mean Q LCXg = 31.7 ± 10.1 mL/min) determined by simulations for the 7 patients were in acceptable agreement with the clinical measured values presented in Table 2. They are also in agreement with values reported in the literature: the off-pump flow rate in the left internal mammary artery is given by Kjaergard et al 12 as 34.4 ± 2.9 mL/ min and as 27.22 ± 15.55 mL/min by Schmitz et al 22 The flow rates across the stenoses Q LAD1 (mean Q LAD1 = 4.1 ± 1.4 mL/min) and Q LCX1 (mean Q LCX1 = 7.0 ± 2.2 mL/min) become small due to the presence of the left bypasses. However, the flow in RCA capillaries Q RCAc is not improved by the presence of the left grafts, as compared to the case (0G) (Q RCAc (2G) = 24.1 ± 8.1 mL/ min vs. Q RCAc (0G) = 24.4 ± 9.1 mL/min).…”

Section: Case (2g): Left Coronary Grafts Working and Right Graft Clampedsupporting

confidence: 91%

“…This is an approximation, since these values probably vary slightly with the revascularization state of the patients (0G, 1G, 2G) due to the surgical procedure. 22,25 However, due to the low pressure drop in the grafts, the increase of flow rate in a capillary region due to the presence of a graft is associated with an increase of the corresponding P i pressure. Consequently, from a mechanical point of view, the ratios…”

Section: Resultsmentioning

confidence: 99%

“…This observation may be related to a physiological autoregulation like vasodilatation or vasoconstriction of the different coronary artery branches due to the partial off-pump revascularization. 22 Kjaergard et al 12 found a vein graft flow rate of 37.8 ± 5.4 mL/ min for off-pump coronary bypasses in men. This result fits with the (1G) clinical Q RCAg values measured in our study: Q RCAg = 36 ± 15 mL/min.…”

Section: Case (1g): Right Graft Working; No Left Graftsmentioning

confidence: 99%

See 2 more Smart Citations

Analog Electrical Model of the Coronary Circulation in Case of Multiple Revascularizations

Maasrani

Verhoye²,

Drochon³

2008

Ann Biomed Eng

View full text Add to dashboard Cite

In this work, we propose an analog electrical model of the coronary circulation for patients with obstructive disease undergoing revascularization. In this clinical situation, the collateral circulation to the occluded artery is difficult to ascertain via preoperative measurements and well-developed collaterals might induce long-term restenosis of the revascularized artery due to flow competition mechanisms. The proposed model allows an original biomechanical analysis of per-operative hemodynamic data in order to assess quantitative evaluation of pressures and flows inside the native stenosed arteries, the collateral network and the bypass grafts. Average cardiac cycle values are analysed. In the case of 3-vessel disease and chronic occlusion of the right coronary artery, the quantitative results confirm the protective effects of the collateral flows in the pathological situation, but also show that the revascularization of the occluded right artery is fully justified since the collateral flows remain low, even when the left territory is revascularized. The model thus provides a computational tool to evaluate therapeutic strategies for each patient.

show abstract

Section: Case (2g): Left Coronary Grafts Working and Right Graft Clampedsupporting

confidence: 91%

Section: Resultsmentioning

confidence: 99%

Section: Case (1g): Right Graft Working; No Left Graftsmentioning

confidence: 99%

See 1 more Smart Citation

Analog Electrical Model of the Coronary Circulation in Case of Multiple Revascularizations

Maasrani

Verhoye²,

Drochon³

2008

Ann Biomed Eng

View full text Add to dashboard Cite

show abstract

“…Schmitz et al [20] reported graft flow values of LITA-ADA in the off-pump group, with an average of 27.92 ml / min, values which are smaller than those observed in the on-pump group, in which the average value was 40.25 ± 22.92 ml / min. This difference was attributed to secondary coronary vasodilation to acidosis during EC and less need for use of noradrenaline in this group.…”

Section: Discussionmentioning

confidence: 89%

Flowmetry of left internal thoracic artery graft to left anterior descending artery: comparison between on-pump and off-pump surgery

Neto

Guedes

Soares

et al. 2012

Rev Bras Cir Cardiovasc

View full text Add to dashboard Cite

Fluxometria da artéria torácica interna esquerda na revascularização da artéria descendente anterior com e sem circulação extracorpóreaFlowmetry of left internal thoracic artery graft to left anterior descending artery: comparison between on-pump and off-pump surgery Abstract Background: Off-pump coronary bypass grafting (OPCAB) has become a widely used technique. Coronary flowmetry is the most common method employed to assess graft patency, nevertheless, few studies compare flow patterns between ONCAB and OPCAB surgery. The objective of this study was to compare flowmetry data in left internal mammary artery grafts bypasses to the left anterior descendent artery.Methods: From March to September of 2010, thirty-five consecutive, non-randomized patients underwent CABG and were retrospectively evaluated. Ten patients were located on group A (On Pump), and twenty-five on group B (Off Pump). The mean graft flow (MGF), pulsatile index (PI) and diastolic filling (DF) were obtained using Transit Time Flowmetry (TTFM). The Fisher exact test, and Mann Whitney test were used, and a P value of < 0.05 was considered to indicate statistical significance.Results: There were no deaths, AMI, re-interventions or PTCA in a 30-day period. The number of bypasses performed per patient was 2.3 ± 0.8 in the OPCAB group, and 2.2 ± 0.6 in the ONCAB group, with no significant difference (P=0.10). The median of mean flow was 23 ml/min on group A, and 25 ml/min on group B (P=0.34). Diastolic filling percentage was 56% on group A, and 56.9% on group B (P=0.86). Pulsatile Index was 2.3 on group A, and 2.2 on group B (P=0.82).Conclusions: There was no difference between TTFM values (MF, PI and DF) in patients operated with or without cardiopulmonary bypass. Rev Bras Cir Cardiovasc 2012;27(2):283-9 Descriptors

show abstract

“…7,9,22,35,36 The results of clinical trials by Desai et al showed that the sensitivity and specifi city of TTFM in detecting greater than 50% stenosis or occlusion were 25% and 98.4%, respectively. 35 ICG imaging with those of TTFM, but this comparison may not be useful.…”

Section: Usability Of the Icg Imaging System In Cabgmentioning

confidence: 99%

Assessing intraoperative blood flow in cardiovascular surgery

2011

View full text Add to dashboard Cite

Off-pump coronary arterial bypass grafting and new surgical apparatus and techniques have decreased the mortality rate associated with this procedure to approximately 1.5%. If we could detect problems in the constructed coronary anastomoses by an alternative imaging system to coronary angiography during surgery, decisions to revise the surgical procedure could be made without hesitation. Meanwhile, the intraoperative direct evaluation of intestinal blood flow during abdominal aortic aneurysmal surgery is required to prevent ischemic colitis, which is a devastating complication. Indocyanine green (ICG) has recently improved ophthalmic angiography and the navigation systems of oncological surgery. The fluorescence illumination of ICG with a near-infrared light is captured on camera. In coronary arterial surgery, the ICG imaging system is also becoming increasingly useful. A new ICG imaging system, the HyperEye Medical System (HEMS), provides a clear view of the blood flow and ischemic area with color visualization. Furthermore, its combination with a quantitative blood flow assessment tool such as transit time flow measurement could improve the accuracy of intraoperative examination. In this review, we evaluate the current strategies of assessing blood flow intraoperatively with an ICG imaging system in cardiovascular surgery.

show abstract

Transit time flow measurement in on-pump and off-pump coronary artery surgery

Cited by 37 publications

References 17 publications

Analog Electrical Model of the Coronary Circulation in Case of Multiple Revascularizations

Analog Electrical Model of the Coronary Circulation in Case of Multiple Revascularizations

Flowmetry of left internal thoracic artery graft to left anterior descending artery: comparison between on-pump and off-pump surgery

Assessing intraoperative blood flow in cardiovascular surgery

Contact Info

Product

Resources

About