INTRAOPERATIVE FLOWMETRY FOR GRAFT ASSESSMENT IN CORONARY ARTERY BYPASS GRAFTING. OUR EXPERIENCE

Abstract

Introduction: Cardiovascular diseases and coronary artery disease (CAD) in particular are the leading causes of death all around the world. At presence, coronary artery bypass grafting (CABG) is one of the most common cardiac operations worldwide. Material and methods: During a three-year period (between 2014 and 2016), a total of 761 CAD patients hospitalized in the Department of Cardiac Surgery, St. Marina University Hospital of Varna underwent CABG surgery. In 64 patients, several transit time flowmetry (TTFM) parameters were assessed. A total of 161 grafts, 125 arterial, 58 in off-pump (OPCAB) and 67 in on-pump CABG as well as 36 venous conduits, 18 in both OPCAB and CABG each were carried out. Results: In arterial grafts, mean flow was of 30.7±23.8 mL/min and mean pulsatile index (PI) was of 2.8±1.1 while in venous ones, the mean flow was of 30.9±19.3 mL/min and the mean PI of 2.5±0.9. The corresponding figures in OPCAB and CABG were 28.8±13.8 mL/min and 2.9±1.04 as well as 36.3±0.3 mL/min and 2.4±0.1, respectively. There were two lethal cases due to cardiogenic shock. TTFM assessment of conduit patency identified that only 3.7% of the anastomoses were at risk for postoperative failure. Conclusion : TTFM is a simple, easy and rapid diagnostic method which allows for immediate and precise objective evaluation of the status of the graft anastomosis in CABG and OPCAB.