Análisis de predictores independientes del flujo del bypass coronario en pacientes intervenidos de revascularización miocárdica aislada

Abstract

Introduction and objectiveThe transit time flowmeter allows knowing two parameters: the mean bypass flow and pulsatility index. These two parameters, when altered, can suggest a bypass stenosis. Factors other than the permeability of the anastomosis, as the quality of coronary bed, may alter the flow of bypass and complicates its interpretation. The aim of our study is to analyze the independent predictors of the mean flow of aorto-coronary bypasses. MethodsWe collected a retrospective series of 90 consecutive patients who underwent isolated coronary artery bypass grafting by the same surgeon from January 2014 to August 2016. From this series, we have built an electronic database where each record corresponds to one graft and the correspondent single or multiple bypasses. Therefore, we built a database including 185 grafts. Of these, 8 grafts were not analyzed because the flow had not been correctly measured. Therefore, the flow and pulsatility index values of 177 grafts were available for our statistical analysis. ResultsMultiple linear regression analysis detected two independent predictors of bypass flow: sequential saphenous vein graft (partial r value: 0.32; P<.0001) and arterial graft (partial r-value: –0.23; P=.0021). Therefore, our model showed a direct correlation between use of saphenous graft with sequential technique and bypass flow and an inverse correlation between arterial graft use and bypass flow. ConclusionsThe predictors of aorto-coronary bypass flow are the use of an arterial graft (negative coefficient) and the use of a sequential venous graft (positive coefficient). Our statistical model has not identified as a predictor the SYNTAX score nor analyzed as a continuous variable nor as a dichotomous variable.