Importance of Intraoperative Detection of Graft Patency by Using Transit Time Flowmetry and Its Impact on Revascularization of the Myocardium

Abstract

Abstract Background Coronary artery bypass surgery (CABG) has contributed to an increase in survival, quality of life and life expectancy. The anastomotic quality and graft patency is directly associated with both early and long-term clinical results after CABG. It is a complication that can lead to refractory angina, myocardial infarction, arrhythmias, and even mortality. Objectives This study was aiming to evaluate the effect of use of TTFM on the outcome of CABG operations and it was carried out on 100 patients and examined 282 grafts, we use inotropic agents to maintain the systolic pressure at 90- 100 mmHg if the blood pressure was lower than that limit. Patients and Methods An observational exploratory study was carried on 100 patients operated in Police authority hospitals, cardiothoracic surgery department. The study period of the study was 6 months, study population: The included population will be patients with Coronary Artery Disease (CAD) undergoing Coronary Artery Bypass Grafting (CABG) surgery. Results TTFM data was described as two main readings which are MF in ml/min (mean flow), PI (pulsatility index) and it was measured for the all types of the grafts. In MF it was the highest in AO-OM system (34.5 ± 18.46) followed by LIMA- LAD system (33.0 ± 19.65) then AO-Diagonal (31.0 ± 26.38) and lastly AO-RCA(29.50 ± 32.22). For the PI the lowest measurements was 0.8 and it was for both LIMA to LAD and then 1.2 for AO-OM system and 1.4 for AO-DIAG system and 1.8 for AO-RCA system. The most important finding in this study which represents the usefulness of the usage of TTFM is how much grafts needed to be revised according to the grafts measurements and it was 14 grafts in 14 patients (one grafts for each patient) among 100 patients which account for 14%. Conclusion Regarding the other studies that compare the TTEM with other ways for detection of graft patency, they prefer the TTFM due to: TTFM is easy to use, accurate and relatively inexpensive, TTFM helps prevent missed technical surgical errors in distal and proximal anastomosis, it has shown that TTFM improved outcome in many situations, TTFM provides excellent documentation of the surgical outcome and allows for better understanding of procedural complications.