Intraoperative coronary grafts flow measurement using the TTFM flowmeter: results from a domestic sample

Abstract

Objective: To evaluate intraoperative graft patency and identify grafts under risk of early occlusion.Methods: Fifty four patients were submitted to coronary artery bypass surgery and the graft flow was assessed by the Flowmeter (Medtronic Medistim), which utilizes the TTFM method. Three patients had left main disease and 48 had normal or mildly reduced left ventricular function.Results: In hospital mortality was 3.7% (two patients), one for mesenteric thrombosis and one due to cardiogenic chock. Seventeen patients (34%) were submitted to off pump CABG. Arterial Graft flow measures ranged from 8 to 106 ml/min (average 31.14 ml/min), and venous grafts flow ranged from 9 to 149 ml/min (average 50.42 ml/min).Conclusion: Flowmeter use represents higher safety both for patients and surgeons. Even under legal aspects, the documentation provided by the device can avoid future questionings. Bras Cir Cardiovasc 2012;27(3):401-4 Descriptors

Current status of intra-operative graft assessment: Should it be the standard of care for coronary artery bypass graft surgery?

“…NICE in January 2018 has updated Medical Technology Guidance 8 (MTG8) with the new Medistim devices, the MiraQ systems (MiraQ Cardiac, MiraQ Vascular, MiraQ Ultimate, Medistim, Oslo, Norway) by reviewing four recent studies . Capital and operating costs of the MiraQ systems, labor, and operative time for use of the MiraQ were plotted against the cost of patient complications that may be reduced with use of the MiraQ (MI, rehabilitation for MI, deep sternal wound infection, and use of the intra‐aortic balloon pump).…”

Importance of LV Venting after ECMO Implantation in Post-Cardiotomy Syndrome: A Case Report

“…As it is clearly shown in our case, one of the reasons for worse myocardial recovery is low coronary perfusion and low flow in bypass-grafts after CABG in distended LV. The use of Transient Time Flowmeter (TTFM) provides data on the flow (ml/min), pulsatility index (PI) and percentage of diastolic flow in grafts with which the graft patency can be assessed [5]. In our patient, we observed low values of flow (<10 ml/min) and high PI (>5) on TTFM, which are the signs of inadequate bypass-graft function, before venting and significantly better values (TTFM flow > 20 ml/min, PI < 2) afterwards (Figure 1 and Figure 2).…”

Bilateral Semi-Skeletonized IMA; Less Thermal Injury, Easier to Harvest, Early Post Operative Comparison with Single IMA Patients After CABG

“…However, occlusion begins to develop due to thrombosis in the first month post-operation in 13-14% of venous grafts. One year after the operation, proliferation starts in smooth muscle cells in the intima of the vein wall [18,21]. This is angiographically seen as a 25-30% shrinking of the graft diameter.…”