The predictive value of intraoperative transit-time flow measurement parameters for early graft failure in different target territories

AbstractTransit-time flow measurement (TTFM) has been increasingly applied to detect graft failure during coronary artery bypass grafting (CABG), because TTFM is less invasive, more reproducible, and less time consuming. Many authors have attempted to validate TTFM and to gain the clear cutoff values and algorithm in TTFM to predict graft failure. The TTFM technology has also been shown to be a useful tool to investigate CABG graft flow characteristics and coronary circulation physiology. It is important to recognize the practical roles of TTFM in the cardiac operating room by review and summarize the literatures.

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Intraoperative transit time flow measurement to predict clinical outcomes in patient undergoing on pump coronary artery bypass graft

International Surgery Journal ◽

10.18203/2349-2902.isj20171129 ◽

2017 ◽

Vol 4 (4) ◽

pp. 1286

Author(s):

Chollada Suwannachod ◽

Nakorn Boonme

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Graft ◽

Clinical Outcomes ◽

Transit Time ◽

Graft Failure ◽

Flow Measurement ◽

Artery Bypass ◽

Bypass Graft ◽

Artery Bypass Graft ◽

Time Flow

Background: Transit time flow measurement (TTFM) is used for intraoperative graft measurement to estimate graft failure. PI≤3 was suggested because it shows lower incidence of early graft failure. Objective of the study was to compare myocardial function and clinical outcomes of patients who underwent coronary artery bypass graft (CABG) surgery, between PI≤3 in all grafts (optimal group) and PI >3 in one or more grafts (suboptimal group) by Transit time flow measurement (TTFM).Methods: 90 patients who underwent CABG since June 2012 to December 2014 were included. Patients were classified into 2 groups: Optimal group (n=32) and Suboptimal group (n=58). CABG with intraoperative TTFM was performed as standard. Postoperative outcomes of both groups were compared.Results: Patients whose postoperative EF was increased were found in optimal group more than suboptimal group (62.1% vs 25%, p<0.001). The patients whose postoperative EF increased equal or more than 5% was found in optimal group more than suboptimal group (73.2% vs 25%, p=0.002). Suboptimal group found one patient with myocardial infarction but optimal group found none (3.13% and 0%). Postoperative atrial fibrillation and prolong ventilator more than 48 hours were found in suboptimal group more than optimal group (43.75% vs 37.93%, 62.50% vs 37.93%). In midterm, postoperative follow-up, all-cause mortality in suboptimal group was higher than optimal group (3.13% vs 1.72).Conclusions: Optimal group had patients whose postoperative EF significantly increased more than suboptimal group. Tendency of finding postoperative complications in suboptimal group was more than in optimal group.

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Predicting Midterm Coronary Artery Bypass Graft Failure by Intraoperative Transit Time Flow Measurement

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2008.04.023 ◽

2008 ◽

Vol 86 (2) ◽

pp. 532-536 ◽

Cited By ~ 40

Author(s):

Yoshiyuki Tokuda ◽

Min-Ho Song ◽

Hideki Oshima ◽

Akihiko Usui ◽

Yuichi Ueda

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Graft ◽

Coronary Artery Bypass ◽

Transit Time ◽

Graft Failure ◽

Flow Measurement ◽

Artery Bypass ◽

Bypass Graft ◽

Artery Bypass Graft ◽

Time Flow

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Role of Coronary Graft Flow Measurement During Reoperations for Early Graft Failure After Off-Pump Coronary Revascularization

Journal of Cardiac Surgery ◽

10.1111/j.1540-8191.1999.tb01006.x ◽

1999 ◽

Vol 14 (5) ◽

pp. 342-347 ◽

Cited By ~ 7

Author(s):

Marco Ricci ◽

Hratch L. Karamanoukian ◽

Tomas A. Salerno ◽

Giuseppe D'Ancona ◽

Jacob Bergsland

Keyword(s):

Graft Failure ◽

Flow Measurement ◽

Coronary Revascularization ◽

Off Pump ◽

Graft Flow ◽

Early Graft ◽

Early Graft Failure

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Determinants of successful arteriovenous fistulae creation including intraoperative transit time flow measurement

The Journal of Vascular Access ◽

10.1177/1129729819874312 ◽

2019 ◽

Vol 21 (3) ◽

pp. 387-394 ◽

Cited By ~ 1

Author(s):

Alexander Meyer ◽

Eberhard Flicker ◽

Sascha T König ◽

Anne Sabine Vetter

Keyword(s):

Blood Flow ◽

Physical Examination ◽

Arteriovenous Fistula ◽

Transit Time ◽

Predictive Value ◽

Flow Measurement ◽

Arteriovenous Fistulae ◽

Time Flow ◽

First Choice ◽

Fistula Maturation

Background: The prevalence of hemodialysis patients is increasing, and it is important to create the arteriovenous fistula as early as possible to avoid hemodialysis by central venous catheter. International guidelines recommend arteriovenous fistula as the vascular access of first choice. Arteriovenous fistulae are associated with a failure rate of 23%. The success of an arteriovenous fistula can be evaluated intraoperatively by physical examination and by measuring the blood flow. Objectives: The aim of the study is to describe the predictive value of various factors for fistula maturation in the context to the current literature. Methods: We report on a prospective cohort study of 41 patients, undergoing a primary arteriovenous fistula at the upper extremity. The primary endpoint of the study was the successful fistula maturation after 6 weeks. Results: The intraoperative measurement of the blood flow in the outflow vein has been identified as the unique significant parameter for the fistula maturation. Conclusion: The predictive value of intraoperative flow measurement is superior to intraoperative physical examination and could help reduce the fistula dysmaturation rate. Intraoperative transit time flow measurement is an easy method and can be used to predict successful fistula maturation in a high percentage rate.

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