scholarly journals Transit time flow measurement predicts graft patency in off-pump coronary artery bypass grafting upon 5-year angiographic follow-up

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Caiwu Zeng ◽  
Xiaomi Li ◽  
Yan Dai ◽  
Ye Zhou ◽  
Chenglong Li ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Graft Failure ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Graft Patency ◽  
Bypass Grafts ◽  
Off Pump ◽  
Time Flow ◽  
Pump Coronary Artery Bypass

Abstract Objective This retrospective study sought to evaluate the efficacy of transit time flow measurement (TTFM) as a means of predicting bypass graft patency as assessed by coronary artery angiography upon 5-year follow-up. Methods Of 311 patients undergone isolated off-pump coronary artery bypass graft surgery from January 2014 through December 2014, 202 (65%) underwent both intraoperative TTFM and angiography at follow-up. 610 grafts, 202 left internal mammary artery grafts and 408 saphenous vein grafts were checked. Any grafts that exhibited Fitzgibbon type B or O lesions upon angiographic evaluation were considered to be failing. Receiver operating characteristic curves were used to identify the optimal TTFM values for predicting graft patency. Results A total of 610 grafts were included in this analysis, including 202 LIMA grafts and 408 SV grafts, of which 107, 129, 129, and 43 anastomosed to DIAG, OM, PDA, and PLA, respectively. LIMA, DIAG, OM, PDA, and PLA bypass grafts had overall patency rates of 95.0%, 74.8%, 73.6%, 71.5%, and 74.4%, respectively, upon 5-year follow up. No significant differences in TTFM values (MGF, PI, and DF) were observed when comparing outcomes associated with individual or sequential SV grafting. MGF was found to be predictive of graft failure regardless of the target vessel (P < 0.05). While PI was found to predict LIMA, OM, and PDA graft failure (P < 0.05), it was not associated with the failure of grafts associated with DIAG and PLA vessels. Similarly, DF was found to predict OM and PDA graft failure (P < 0.05), but was not significantly associated with the failure of grafts associated with LIMA, DIAG, or PLA vessels. Conclusion LIMA bypass grafts were associated with better 5-year graft patency relative to SV bypass grafts. Similar graft patency rates were observed for both individual and sequential bypass grafts. MGF was able to predict bypass graft failure in patients that underwent off-pump CABG surgery.

scholarly journals Transit Time Flow Measurement Predicts Graft Patency in Off-pump Coronary Artery Bypass Grafting Upon 5-Year Angiographic Follow-up

2020 ◽  
Author(s):  
caiwu zeng ◽  
Xiaomi Li ◽  
Yan Dai ◽  
Ye Zhou ◽  
Chenglong Li ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Graft Failure ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Graft Patency ◽  
Bypass Grafts ◽  
Off Pump ◽  
Time Flow ◽  
Pump Coronary Artery Bypass

Abstract Objective: This retrospective study sought to evaluate the efficacy of transit time flow measurement (TTFM) as a means of predicting bypass graft patency as assessed by coronary artery angiography (CAG) upon 5-year follow-up. Method: Of 311 patients undergone isolated off-pump coronary artery bypass graft (CABG) surgery from January 2014 through December 2014, 202 (65%) underwent both intraoperative TTFM and angiography at follow-up. 610 grafts, 202 left internal mammary artery grafts and 408 saphenous vein grafts were checked. Any grafts that exhibited Fitzgibbon type B or O lesions upon angiographic evaluation were considered to be failing. Receiver operating characteristic (ROC) curves were used to identify the optimal TTFM values for predicting graft patency. Results: A total of 610 grafts were included in this analysis, including 202 LIMA grafts and 408 SV grafts, of which 107, 129, 129, and 43 anastomosed to DIAG, OM, PDA, and PLA, respectively. LIMA, DIAG, OM, PDA, and PLA bypass grafts had overall patency rates of 95.0%, 74.8%, 73.6%, 71.5%, and 74.4%, respectively, upon 5-year follow up. No significant differences in TTFM values (MGF, PI, and DF) were observed when comparing outcomes associated with individual or sequential SV grafting. MGF was found to be predictive of graft failure regardless of the target vessel (P<0.05). While PI was found to predict LIMA, OM, and PDA graft failure (P<0.05), it was not associated with the failure of grafts associated with DIAG and PLA vessels. Similarly, DF was found to predict OM and PDA graft failure (P<0.05), but was not significantly associated with the failure of grafts associated with LIMA, DIAG, or PLA vessels.Conclusion: LIMA bypass grafts were associated with better 5-year graft patency relative to SV bypass grafts. Similar graft patency rates were observed for both individual and sequential bypass grafts. TTFM was able to predict bypass graft failure in patients that underwent off-pump CABG surgery, with MGF cut-off values for LIMA, DIAG, OM, PDA, and PLA grafts being 14.5 mL/min, 14.5 mL/min, 14.5 mL/min, 13.5 mL/min, and 16.5 mL/min, respectively.

Optimal use of instruments for off-pump coronary artery bypass grafting

2021 ◽  
pp. 309-314
Author(s):  
Bobby Yanagawa ◽  
Michael E. Halkos ◽  
John D. Puskas
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Graft Patency ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Off Pump ◽  
Time Flow ◽  
Pump Coronary Artery Bypass

Off-pump coronary artery bypass grafting is a technically demanding procedure that allows for avoidance of the deleterious consequences of cardiopulmonary bypass and can facilitate a no- or minimal-aortic manipulation procedure. To ensure the construction of a precise and reproducible off-pump coronary anastomosis, adjunctive tools have been developed that, when used correctly, can create a near motionless and bloodless field, mimicking conditions of anastomosis on an arrested heart. These include cardiac positioning and stabilization devices, occlusive tapes and intracoronary shunts, and misted blowers. The chapter also discusses the use of a proximal anastomosis device to mitigate the risk of stroke and a transit-time flow meter for confirmation of graft patency. It offers practical suggestions on the correct use of each device as well as common pitfalls to avoid.

Meta-Analysis of Randomized Trials Comparing Off-Pump With On-Pump Coronary Artery Bypass Graft Patency

2005 ◽  
Vol 80 (6) ◽  
pp. 2121-2125 ◽  
Author(s):  
Alessandro Parolari ◽  
Francesco Alamanni ◽  
Gianluca Polvani ◽  
Marco Agrifoglio ◽  
Yong Bing Chen ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Graft Patency ◽  
Artery Bypass Graft ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

scholarly journals Respiratory physiotherapy and incidence of pulmonary complications in off-pump coronary artery bypass graft surgery: an observational follow-up study

2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Isabel Yánez-Brage ◽  
Salvador Pita-Fernández ◽  
Alberto Juffé-Stein ◽  
Ursicino Martínez-González ◽  
Sonia Pértega-Díaz ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Pulmonary Complications ◽  
Artery Bypass Graft ◽  
Off Pump ◽  
Follow Up Study ◽  
Respiratory Physiotherapy ◽  
Pump Coronary Artery Bypass

Coronary Artery Bypass Graft Failure After On-Pump and Off-Pump Coronary Artery Bypass: Findings From PREVENT IV

2008 ◽  
Vol 85 (2) ◽  
pp. 494-500 ◽  
Author(s):  
Mitchell J. Magee ◽  
John H. Alexander ◽  
Gail Hafley ◽  
T. Bruce Ferguson ◽  
C. Michael Gibson ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Graft Failure ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

Noninvasive Follow-Up of Coronary Artery Bypass Graft Patency Using Multi-Slice Computed Tomography

2006 ◽  
Vol 55 (5) ◽  
pp. 451
Author(s):  
Seung Ho Joo ◽  
Byoung Wook Choi ◽  
Jae Seung Seo ◽  
Young Jin Kim ◽  
Tae Hoon Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Graft Patency ◽  
Artery Bypass Graft

Ten-Year Outcome Analysis of Off-Pump Sequential Grafting: Single Surgeon, Single Center Experience

2012 ◽  
Vol 15 (3) ◽  
pp. 136 ◽  
Author(s):  
Shahzad G. Raja ◽  
Kareem Salhiyyah ◽  
Manoraj Navaratnarajah ◽  
Muhammad Umar Rafiq ◽  
Jeremy Felderhof ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Medium Term ◽  
Artery Bypass Grafting ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

<p><b>Objectives:</b> Despite increasing recognition that off-pump coronary artery bypass surgery and sequential grafting strategy individually are associated with improved outcomes, concerns persist regarding the safety and efficacy of combining these 2 techniques. We compared in-hospital and midterm outcomes for off-pump multivessel sequential and conventional coronary artery bypass grafting.</p><p><b>Methods:</b> From September 1998 to September 2008, 689 consecutive patients received off-pump multivessel sequential coronary artery bypass grafting performed by a single surgeon. These patients were propensity matched to 689 patients who underwent off-pump coronary artery bypass grafting without sequential anastomoses. A retrospective analysis of prospectively collected perioperative data was performed. In addition, medical notes and charts of all the study patients were reviewed. The mean duration of follow-up was 5.1 � 2.0 years.</p><p><b>Results:</b> The major in-hospital clinical outcomes in the sequential and control groups were found to be similar. After adjusting for clinical covariates, sequential grafting was not an independent predictor of in-hospital adverse events (odds ratio [OR], 1.18; 95% confidence interval [CI], 0.86-1.50; <i>P</i> = .31), medium-term mortality (hazard ratio [HR], 1.26; 95% CI, 1.06-1.32; <i>P</i> = .92), and readmission to hospital (HR, 1.12; 95% CI, 0.96-1.20; <i>P</i> = .80). Sequential grafting was an independent predictor of receiving more than 3 distal anastomoses (OR, 7.46; 95% CI, 4.27-11.45; <i>P</i> < .0001). Risk-adjusted survival was 89% for sequential grafting patients and 88% for conventional grafting patients (<i>P</i> = .96) during the medium-term follow-up.</p><p><b>Conclusion:</b> Our analysis confirms the short- and midterm safety and efficacy of off-pump sequential coronary artery bypass grafting.</p>

Sign in / Sign up

Export Citation Format

Share Document