Cut-Off Values for Transit Time Flowmetry: Are the Revision Criteria Appropriate?

Abstract

TTF can identify non-functional grafts during CABG, but is of questionable value to improve one-year graft patency.

Transit-Time Flow Measurement as a Predictor of Coronary Bypass Graft Failure at One Year Angiographic Follow-Up

“…A sub study from the GRIIP trial investigating 65 vein grafts in 44 patients found a significant difference in TTFM with 38.3 mL/min ± 17.0 in patent grafts versus 27.6 mL/min ± 11.7 (p < 0.01) in vein grafts with failure (21 occluded and one >50% stenosis) at one year angiographic follow‐up. The regression analysis showed an OR of 0.947 per 1 mL/min increase in graft flow (p = 0.014), which is well in line with our results …”

“…The regression analysis showed an OR of 0.947 per 1 mL/min increase in graft flow (p ¼ 0.014), which is well in line with our results. 14 Coronary bypass grafts anastomosed to small coronary arteries, defined as a diameter <1.5 mm, have been shown to result in higher mortality. 15 Our results show that small coronary vessel size generally results in lower flow in the anastomosed graft and supports the hypothesis that anastomoses to coronary vessels smaller than 1.5 mm could contribute to suboptimal outcome.…”

Transesophageal Echocardiographic Estimation of Coronary Sinus Blood Flow for Predicting Favorable Postoperative Transit Time Coronary Graft Flow Measurements: A Pilot Study

“…Moreover, with an increasing number of studies documenting graft revision at a PI > 5, there is enough evidence in support of an ideal PI of less than 3. 10,[32][33][34] Echocardiographic demonstration of an augmented CSBF has guided revascularization in a number of studies. Meenakshi et al estimated CSBF in patients undergoing angioplasty using transthoracic echocardiography.…”

Intraoperative graft assessment during coronary artery bypass surgery

“…Flow pattern is predominantly diastolic in all grafts but is more marked in the left coronary system; because of a smaller right ventricular transmyocardial pressure gradient, there is a comparatively greater systolic flow component in grafts to the right coronary system [2]. A number of studies have reported the usefulness and efficacy of TTFM [10,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Takami et al [12,13] described the usefulness of TTFM in the detection of intraoperative graft failure of several types of grafts.…”