Graft revision after transit time flow measurement in off-pump coronary artery bypass grafting

Giuseppe D'Ancona; Hratch L. Karamanoukian; Marco Ricci; Susan Schmid; Jacob Bergsland; Tomas A. Salerno

doi:10.1016/S1010-7940(00)00332-8

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Graft revision after transit time flow measurement in off-pump coronary artery bypass grafting

Journal article

Open access

Peer reviewed

Graft revision after transit time flow measurement in off-pump coronary artery bypass grafting

Giuseppe D'Ancona, Hratch L. Karamanoukian, Marco Ricci, Susan Schmid, Jacob Bergsland and Tomas A. Salerno

European journal of cardio-thoracic surgery, Vol.17(3), pp.287-293

03/2000

DOI: 10.1016/S1010-7940(00)00332-8

PMID: 10758390

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Abstract

Objective: To determine whether coronary graft patency can be predicted by transit time flow measurement (TTFM). Methods: From May 1 1997 to December 31 1998, TTFM was prospectively evaluated in 409 patients undergoing coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB). All grafts (1145) were tested with TTFM. Results: Thirty-seven out of 1145 grafts (3.2%) were revised in 33 patients (7.6%). In six cases (18.1%) use of CPB was necessary during revision due to hemodynamic instability. The remaining patients underwent revision off-pump. Thirty-four grafts (91.9%) were revised for both low flow and abnormal flow curve patterns. Findings at revision included: thrombosis of the anastomosis (n=6), stenosis at the toe or heel of the anastomosis (n=8), coronary flap or dissection (n=5), dissection of the internal mammary artery (n=5), graft kinking (n=4), flap at proximal anastomosis (n=1), coronary stenosis distal to the graft (n=3), and no findings (n=2). After revision all flow values and flow patterns improved. Although three additional grafts (8.1%) were revised for low flow (≪7 ml/min) despite normal flow patterns, there were no findings at revision and flow values and curves remained unchanged after revision. Postoperatively, one patient developed a stroke (3%), one had an acute myocardial infarction (MI) (3%), one had a sternal wound infection (3%), and one required prolonged ventilatory support (3%). Conclusion: Evaluation of TTFM is valuable in determining the status of a coronary graft after CABG. Correct interpretation of flow patterns allows for correction of abnormalities prior to chest closure.

Graft

Off-coronary pulmonary bypass

Revision

Transit time flow measurement

Details

Title: Subtitle: Graft revision after transit time flow measurement in off-pump coronary artery bypass grafting
Creators: Giuseppe D'Ancona - Center for Minimally Invasive Cardio-thoracic Surgery, Kaleida Health Systems and the State University of New York at Buffalo, Buffalo
Hratch L. Karamanoukian - Center for Minimally Invasive Cardio-thoracic Surgery, Kaleida Health Systems and the State University of New York at Buffalo, Buffalo
Marco Ricci - Center for Minimally Invasive Cardio-thoracic Surgery, Kaleida Health Systems and the State University of New York at Buffalo, Buffalo
Susan Schmid - Center for Minimally Invasive Cardio-thoracic Surgery, Kaleida Health Systems and the State University of New York at Buffalo, Buffalo
Jacob Bergsland - Center for Minimally Invasive Cardio-thoracic Surgery, Kaleida Health Systems and the State University of New York at Buffalo, Buffalo
Tomas A. Salerno - Center for Minimally Invasive Cardio-thoracic Surgery, Kaleida Health Systems and the State University of New York at Buffalo, Buffalo
Resource Type: Journal article
Publication Details: European journal of cardio-thoracic surgery, Vol.17(3), pp.287-293
DOI: 10.1016/S1010-7940(00)00332-8
PMID: 10758390
NLM abbreviation: Eur J Cardiothorac Surg
ISSN: 1010-7940
eISSN: 1873-734X
Publisher: Elsevier Science B.V
Language: English
Date published: 03/2000
Academic Unit: Cardiothoracic Surgery
Record Identifier: 9984322877102771

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