HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Eugene K.W. Sim Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Leong, D. K.H. Articles by Sim, E. K.W. Search for Related Content PubMed PubMed Citation Articles by Leong, D. K.H. Articles by Sim, E. K.W. Related Collections Coronary disease Related Article

Ann Thorac Surg 2005;79:854-857
© 2005 The Society of Thoracic Surgeons

---

Original article: Cardiovascular

Transit-Time Flow Measurement is Essential in Coronary Artery Bypass Grafting

^a Department of Cardiac, Thoracic, and Vascular Surgery, National University Hospital
^b Faculty of Medicine, National University of Singapore, Singapore, Singapore

Accepted for publication June 2, 2004.

^* Address reprint requests to Dr Sim, Department of Cardiac, Thoracic, and Vascular Surgery, National University Hospital, Singapore, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore (E-mail: sursimkw{at}nus.edu.sg).

BACKGROUND: Patent bypass grafts are fundamental to successful coronary artery bypass grafting. Intraoperative flow measurement through newly constructed grafts is a test of patency. We studied the use of transit-time flow measurement to determine its ability to detect technical errors in grafts, to measure the mean flow norms for Asian patients, and to compare arterial and vein grafts.

METHODS: From January 1, 2001, to June 30, 2002, 116 patients underwent isolated primary coronary artery bypass grafting. Sixty-seven patients underwent conventional coronary artery bypass grafting and 49 patients underwent off-pump coronary artery bypass grafting. There were 125 arterial and 197 vein grafts. Transit-time flow measurement was carried out on all completed grafts. Graft patency was assessed using flow curves, mean flow, and pulsatility index. Average of mean flows was calculated to determine mean flow norms. Arterial and vein grafts were compared by statistical analysis between the variables mean flow and pulsatility index.

RESULTS: In 6 patients with seven grafts, intraoperative graft assessment detected technical errors, which were corrected. Average mean flow was 37.4 ± 23.5 mL/min for left anterior descending coronary artery–to–left internal mammary artery grafts, and values ranging from 21.2 to 36.0 mL/min for the rest. There were no statistically significant differences in mean flow or pulsatility index between arterial and vein grafts.

CONCLUSIONS: Transit-time flow measurement enables technical problems to be diagnosed accurately, allowing prompt revision of grafts. It should be mandatory in coronary artery bypass grafting to improve surgical outcomes.

Related Article

INVITED COMMENTARY

Beat H. Walpoth
Ann. Thorac. Surg. 2005 79: 857-858. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				Y. Takami, K. Tajima, S. Terazawa, N. Okada, K. Fujii, and Y. Sakai Transit-time flow characteristics of in situ right gastroepiploic arterial grafts in coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., September 1, 2009; 138(3): 669 - 673. [Abstract] [Full Text] [PDF]

				N. Becit, B. Erkut, M. Ceviz, Y. Unlu, A. Colak, and H. Kocak The impact of intraoperative transit time flow measurement on the results of on-pump coronary surgery Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 313 - 318. [Abstract] [Full Text] [PDF]

				R. Eckardt, B. J. Kjeldsen, P. Thayssen, W. Vach, T. Haghfelt, P. F. Hoilund-Carlsen, and L. Andersen Frequent change of procedure during coronary artery bypass surgery suggests insufficient preoperative diagnostic strategy Interactive CardioVascular and Thoracic Surgery, June 1, 2007; 6(3): 298 - 302. [Abstract] [Full Text] [PDF]

				G. Di Giammarco, M. Pano, S. Cirmeni, P. Pelini, G. Vitolla, and M. Di Mauro Predictive value of intraoperative transit-time flow measurement for short-term graft patency in coronary surgery. J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 468 - 474. [Abstract] [Full Text] [PDF]

				H.-G. Ryu, J.-H. Bahk, and K.-B. Kim Sympathetic stimulation increases the blood flow through the in situ right gastroepiploic artery graft after off-pump coronary artery bypass graft surgery. Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 948 - 951. [Abstract] [Full Text] [PDF]

				J. Garbade, C. Ullmann, M. Hollenstein, M. J. Barten, S. Jacobs, S. Dhein, T. Walther, J. F. Gummert, V. Falk, and F.-W. Mohr Modeling of temperature mapping for quantitative dynamic infrared coronary angiography for intraoperative graft patency control J. Thorac. Cardiovasc. Surg., June 1, 2006; 131(6): 1344 - 1351. [Abstract] [Full Text] [PDF]

				R. S. Poston, J. Gu, J. M. Brown, J. S. Gammie, C. White, L. Nie, R. N. Pierson III, and B. P. Griffith Endothelial injury and acquired aspirin resistance as promoters of regional thrombin formation and early vein graft failure after coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., January 1, 2006; 131(1): 122 - 130. [Abstract] [Full Text] [PDF]