Intraoperative Graft Patency Verification in Coronary Artery Surgery: Modern Diagnostic Tools

D’Ancona, Giuseppe; Bartolozzi, Fabio; Bogers, Ad J.J.C.; Pilato, Michele; Parrinello, Matteo; Kappetein, Arie Pieter

doi:10.1053/j.jvca.2008.11.008

Cited by 12 publications

(13 citation statements)

References 27 publications

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“…The transit time flow (TTF) measurement is the most frequent intraoperative diagnostic method for verification of coronary graft patency. TTF measurement is independent of the hematocrit level, heart rate and thickness of the vessel wall [17]. For coronary flow measurements of LIMA, probe (Medi-Stim QuickFit TTF probe; Nydalen, Oslo, Norway) sizes from 2 to 3 mm are generally used.…”

Section: Methodsmentioning

confidence: 99%

Does Diabetes Have an Influence on Regional Deformation Parameters in Patients with Normal Systolic Function during Off-Pump Coronary Artery Bypass Grafting?

et al. 2015

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Objectives: The aim of this study was to assess the recovery of regional myocardial function of the left-ventricular septal wall and the septal site of the mitral valve (MV) annulusby tissue Doppler imaging (TDI). Methods: In 63 (32 diabetic and 31 control) patients having off-pump coronary artery bypass grafting (OPCABG), including the left internal mammary artery (LIMA) and the left anterior descending coronary artery (LAD), TDI measurements were performed before operation (baseline), 5 min after LIMA-LAD revascularization (early reperfusion) and after completion of all anastomoses (after revascularization). Results: Compared to the patients with diabetes, the controls had higher peak systolic velocities of the mid septal segments in the early reperfusion measurement (p = 0.002). After revascularization, values of peak systolic strain at the basal (-10.13 vs. -13.36%, p = 0.044) and mid septal segments (-8.25 vs. -12.69%, p = 0.009) were decreased in the diabetic patients compared to the controls. There was no difference between the groups with respect to the velocities acquired at the septal site of the MV annulus. Conclusions: This study demonstrates an insufficient recovery of regional myocardial function in patients with type II diabetes undergoing OPCABG.

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Section: Methodsmentioning

confidence: 99%

Does Diabetes Have an Influence on Regional Deformation Parameters in Patients with Normal Systolic Function during Off-Pump Coronary Artery Bypass Grafting?

et al. 2015

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“…32 The time it takes for ultrasound beams sent by an ultrasound wave to travel from one crystal across a vessel to the another crystal is called "transit time". 29,32 Blood fl ow such as that measured in a coronary arterial bypass graft, is rated by TTFM based on mean graft fl ow (MGF), pulsatility index (PI), and diastolic fi lling percentage (DF). 32-34 D'Ancona et al explained that mean arterial blood pressure and graft coronary resistance infl uence mean fl ow.…”

Section: Transit Time Flow Measurementmentioning

confidence: 99%

“…32-34 D'Ancona et al explained that mean arterial blood pressure and graft coronary resistance infl uence mean fl ow. 32,33 They found that certain physical factors, such as blood viscosity, graft length, and graft radius, affect the aforementioned parameters. 32,33 Having studied the normal presented transit time patency criteria, the authors have set the following classifi cation criteria, based on previous descriptions: 22…”

Section: Transit Time Flow Measurementmentioning

confidence: 99%

“…While ICG angiography could not provide quantitative measurements, TTFM quantifi ed the graft fl ow in terms of certain parameters, such as MGF, PI, and 8,19,32 The results of the intraoperative examination of TTFM have been documented by several institutions. 7,9,22,35,36 The results of clinical trials by Desai et al showed that the sensitivity and specifi city of TTFM in detecting greater than 50% stenosis or occlusion were 25% and 98.4%, respectively.…”

Section: Usability Of the Icg Imaging System In Cabgmentioning

confidence: 99%

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Assessing intraoperative blood flow in cardiovascular surgery

2011

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Off-pump coronary arterial bypass grafting and new surgical apparatus and techniques have decreased the mortality rate associated with this procedure to approximately 1.5%. If we could detect problems in the constructed coronary anastomoses by an alternative imaging system to coronary angiography during surgery, decisions to revise the surgical procedure could be made without hesitation. Meanwhile, the intraoperative direct evaluation of intestinal blood flow during abdominal aortic aneurysmal surgery is required to prevent ischemic colitis, which is a devastating complication. Indocyanine green (ICG) has recently improved ophthalmic angiography and the navigation systems of oncological surgery. The fluorescence illumination of ICG with a near-infrared light is captured on camera. In coronary arterial surgery, the ICG imaging system is also becoming increasingly useful. A new ICG imaging system, the HyperEye Medical System (HEMS), provides a clear view of the blood flow and ischemic area with color visualization. Furthermore, its combination with a quantitative blood flow assessment tool such as transit time flow measurement could improve the accuracy of intraoperative examination. In this review, we evaluate the current strategies of assessing blood flow intraoperatively with an ICG imaging system in cardiovascular surgery.

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“…The goal of CABG is to achieve complete revascularization with a durable, patent graft without reintervention. Because graft failure can cause perioperative myocardial infarction (PMI) and long-term adverse outcomes, verification of graft patency intra-or postoperatively should be performed [1][2][3][4][5][6]. The PRoject of Ex-vivo Vein Graft ENgineering via Transfection IV (PREVENT IV) trial assessed 22,400 saphenous vein grafts (SVGs) angiographically at 1-year follow-up [7].…”

Section: Introductionmentioning

confidence: 99%

Intraoperative graft assessment during coronary artery bypass surgery

Fukui

2015

Gen Thorac Cardiovasc Surg

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Coronary artery bypass grafting (CABG) is an established revascularization method for treating multivessel coronary artery disease. The goal of CABG is to achieve complete revascularization with a durable, patent graft without reintervention. However, early graft failure, including that associated with technical errors, has been reported. This makes intraoperative verification of graft patency one of the most important ways in which surgeons can reduce the rate of early graft failure. Conventional angiography is considered the gold standard for graft assessment. However, because it is invasive and inconvenient, several alternatives to intraoperative graft assessment have become available that help reduce early graft failure by allowing revision of the anastomosis intraoperatively. The aim of this article is to review the advantages and disadvantages of several intraoperative graft assessment methods for CABG.

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Intraoperative Graft Patency Verification in Coronary Artery Surgery: Modern Diagnostic Tools

Cited by 12 publications

References 27 publications

Does Diabetes Have an Influence on Regional Deformation Parameters in Patients with Normal Systolic Function during Off-Pump Coronary Artery Bypass Grafting?

Does Diabetes Have an Influence on Regional Deformation Parameters in Patients with Normal Systolic Function during Off-Pump Coronary Artery Bypass Grafting?

Assessing intraoperative blood flow in cardiovascular surgery

Intraoperative graft assessment during coronary artery bypass surgery

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