scholarly journals Transit time flow measurement in patients with diffuse coronary artery disease during coronary artery bypass grafting

2020 ◽  
pp. 22-27
Author(s):  
А.А. Ширяев ◽  
Д.М. Галяутдинов ◽  
В.П. Васильев ◽  
В.Ю. Зайковский ◽  
Ш.Д. Мукимов ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Transit Time ◽  
Flow Measurement ◽  
Bypass Surgery ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Graft Occlusion ◽  
Time Flow

Диффузное поражение (ДП) коронарных артерий (КА) — одна из наиболее сложных ситуаций с прогностической точки зрения для выполне- ния операции коронарного шунтирования (КШ). Протяженное коронарное поражение является фактором риска интраоперационной несо- стоятельности и окклюзии шунта в отдаленном периоде. Проведен анализ 14 ретроспективных и 1 рандомизированного исследования приме- нения интраоперационной ультразвуковой флоуметрии при КШ. Ультразвуковая флоуметрия в настоящее время эффективно используется для качественной и количественной оценки кровотока в шунтах КА и, таким образом, позволяет снизить количество технических ошибок при оперативных вмешательствах и улучшить отдаленный прогноз пациентов. При ДП КА часто отмечаются относительно невысокие показатели кровотока по шунтам, а их прогностическое значение для различных трансплантатов однозначно не определено Diffuse lesion (DL) of the coronary arteries (CA) is one of the most difficult situations from a prognostic point of view for performing coronary bypass surgery. The extent of the lesion and the presence of antegrade blood flow are risk factors for intraoperative failure and graft occlusion in the long-term period. The analysis of 14 retrospective and 1 randomized study of the use of intraoperative ultrasound flowmetry or TTFM (transit time flow measurement) for coronary bypass surgery was performed. TTFM is currently effectively used for qualitative and quantitative assessment of blood flow in CA bypass grafts and thus reduces the number of technical errors during surgical interventions and improves the long-term prognosis of patients. At the same time, relatively low blood flow rates for shunts are often observed in CA DL, and their prognostic value for various transplants is not clearly defined

Blood flow assessment by transit time flow measurement and its prognostic impact in coronary bypass surgery

2020 ◽  
Vol 61 (3) ◽  
Author(s):  
Lars Niclauss ◽  
Pier-Giorgio Masci ◽  
Anna G. Pavon ◽  
David Rodrigues ◽  
Juerg Schwitter
Keyword(s):  
Blood Flow ◽  
Transit Time ◽  
Flow Measurement ◽  
Bypass Surgery ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Prognostic Impact ◽  
Time Flow

Enhancement of flow measurement for graft verification

2019 ◽  
Vol 27 (8) ◽  
pp. 646-651
Author(s):  
Yury Y Vechersky ◽  
Vasily V Zatolokin ◽  
Boris N Kozlov ◽  
Aleksandra A Nenakhova ◽  
Vladimir M Shipulin
Keyword(s):  
Coronary Artery ◽  
Transit Time ◽  
Flow Measurement ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Flow Measurements ◽  
Technical Problems ◽  
Technical Errors ◽  
Time Flow ◽  
Coronary Bypass Grafts

Background We aimed to evaluate multiple transit-time flow measurements during coronary artery bypass grafting. Methods Transit-time flow measurements were performed first on the arrested heart both with and without a proximal snare on the target coronary artery, second, after weaning from cardiopulmonary bypass, and third, before chest closure. Results Among the 214 grafts considered, 9 (4.2%) were patent and 6 (2.8%) were failing. In the failed grafts, an abnormal transit-time flow was found during the first measurement, in 5 (2.3%) cases with a proximal snare and in one (0.47%) without a snare. In these cases, technical errors with the distal anastomoses were found and immediately corrected. A problem with the proximal anastomosis was found in one graft during the second measurement and corrected right away. Bending due to excessive length was found in 2 (0.93%) grafts during the third measurement, and graft repositioning was performed. The first transit-time flow measurement showed that mean graft flow was significantly decreased with a proximal snare compared to without a proximal snare, throughout the entire coronary territory. Pulsatility index during the first transit-time flow measurement was higher with a proximal snare than without one. Conclusions The 3-time transit-time flow measurement strategy makes it possible to verify and immediately correct technical problems with coronary bypass grafts.

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

2018 ◽  
Vol 66 (06) ◽  
pp. 426-433 ◽  
Author(s):  
Yasushi Takagi ◽  
Yoshiyuki Takami
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Transit Time ◽  
Graft Failure ◽  
Flow Measurement ◽  
Coronary Artery Bypass Surgery ◽  
Coronary Circulation ◽  
Artery Bypass ◽  
Flow Characteristics ◽  
Time Flow

AbstractTransit-time flow measurement (TTFM) has been increasingly applied to detect graft failure during coronary artery bypass grafting (CABG), because TTFM is less invasive, more reproducible, and less time consuming. Many authors have attempted to validate TTFM and to gain the clear cutoff values and algorithm in TTFM to predict graft failure. The TTFM technology has also been shown to be a useful tool to investigate CABG graft flow characteristics and coronary circulation physiology. It is important to recognize the practical roles of TTFM in the cardiac operating room by review and summarize the literatures.

Transient liver dysfunction increases surgical site infections after coronary surgery

2018 ◽  
Vol 26 (6) ◽  
pp. 439-445 ◽  
Author(s):  
Rakan I Nazer ◽  
Khalid A Alburikan ◽  
Anhar Ullah ◽  
Ali M Albarrati ◽  
Mazen Hassanain
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Liver Dysfunction ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Surgical Site Infections ◽  
Perioperative Period ◽  
Coronary Bypass Surgery ◽  
Cardiac Procedures

Background Surgical site infections can have a significant impact on cardiac surgical outcome. The liver plays an important role in infection prevention. This study aimed to retrospectively determine whether transient postoperative liver dysfunction after coronary bypass surgery increased surgical site infections. Methods A modified version of the Schindl scoring scale for liver dysfunction was adapted to objectively quantify transient liver dysfunction in the first 7 days after on-pump coronary artery bypass grafting. A retrospective analysis of clinical outcomes at 30 months postoperatively was performed on data of 575 patients who underwent coronary artery bypass between 2014 and 2016. The patients were categorized into a liver dysfunction group (Schindl score ≥ 4) and a non-liver dysfunction group (Schindl score < 4). Results The liver dysfunction group (47.3%) had significantly more patients who were obese, current smokers, and had diabetes, renal impairment, and peripheral vascular disease. Surgical site infections occurred predominantly in the liver dysfunction group (12.1% vs. 0.3%, p < 0.001). The independent predictors of surgical site infection were liver dysfunction, body mass index > 30 kg m−2, and coronary bypass surgery combined with other cardiac procedures. Conclusions Surgical wound infections can be precipitated by multiple factors before, during, and after coronary bypass surgery. Transient liver dysfunction in the perioperative period is associated with an increased rate of surgical infections even after adjusting for known risk factors. Considering this factor as well as other known risks may help to identify and stratify patients with a potentially higher risk of surgical site infections.

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