Intraoperative management in coronary bypass surgery: transit time flow measurement as a means of quality control
M.A. POTEEV, R.A. YAKUBOV
Emergency Hospital, 18 Naberezhnochelninsky Pr., Naberezhnye Chelny, Russian Federation, 423803
Poteev M.A. ― cardiovascular surgeon of the Cardiovascular Surgery Department, tel. (8552) 30-49-78, e-mail: [email protected]
Yakubov R.A. ― Head of the Cardiovascular Surgery Department, tel. (8552) 30-49-50, e-mail: [email protected]
Intraoperative transit time flow measurement (TTFM) is a simple and effective technique for estimating the blood flow in grafts in surgical revascularization of myocardium. The article shows the results of TTFM after performing of CABG in patients who were operated in Naberezhnye Chelny Emergency Hospital in 2014-2016. Clinical examples are presented in the article. In some cases, intraoperative flow measurement helps identify and resolve technical problems with the coronary bypass grafts. However, not all indicators of aberrant flow measurement are signal of technical error.
Key words: cardiac ischemia, CABG, TTFM.
REFERENCES
- Kolesov V.I. Mammary artery-coronary artery anastomosis as method of treatment for angina pectoris. J. Thorac. Cardiovasc. Surg, 1967, 54, pp. 535-44.
- Favaloro R.G. Saphenous vein autograft replacement of severe segmental coronary artery occlusion: operative technique. Ann. Thorac. Surg, 1968, 5, pp. 334-9.
- Marco J.D., Barner H.B., Kaiser G.C. et al. Operative flow measurements and coronary bypass graft patency. J. Thorac. Cardiovasc. Surg, 1976 Apr, 71 (4), pp. 545-7.
- Foxworthy J.V., Monro J.L., Lewis B. The response to papaverine in coronary artery by-pass graft flows. J. Cardiovasc. Surg. (Torino), 1985 Sep-Oct, 26 (5), pp. 439-42.
- De Bono D.P., Samani N.J., Spyt T.J. et al. Transcutaneous ultrasound measurement of blood-flow in internal mammary artery to coronary artery grafts. Lancet, 1992 Feb 15, 339 (8790), pp. 379-81.
- D’Ancona G.1., Karamanoukian H.L., Salerno T.A. et al. Flow measurement in coronary surgery. Heart Surg. Forum, 1999, 2 (2), pp. 121-4.
- Bazylev V.V., Rosseykin E.V., Mikulyak A.I., Karpun’kin O.A. Ultrasonic pre-Ppler flowmetry in intraoperative diagnostics of coronary shunt insolability. Angiologiya i sosudistaya khirurgiya, 2014 (in Russ.).
- The VeriQ system for assessing graft flow during coronary artery bypass graft surgery. NICE medical technologies guidance 8. Issued November 2011. Pp. 1-25
- ESC/EACTS myocardial revascularization Guidelines 2014. European Heart Journal, 2014, 35, pp. 3235-3241.
- Oshima H., Tokuda Y., Araki Y. et al. Predictors of early graft failure after coronary ar-tery bypass grafting for chronic total occlusion. Interact Cardiovasc. Thorac. Surg, 2016, Jul, 23 (1), pp. 142-9.
- Niclauss L. Techniques and standards in intraoperative graft verification transit time flow measurement after coronary artery by passgraft surgery: a critical review. Eur. J. Cardiothorac. Surg, 2016.