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Related Experiment Videos

Flow measurement in coronary surgery.

G D'Ancona1, H L Karamanoukian, T A Salerno

  • 1The Center for Minimally Invasive Cardiac Surgery, Buffalo General Hospital and State University of New York at Buffalo, New York, NY, USA.

The Heart Surgery Forum
|March 29, 2001
PubMed
Summary
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Transit Time Flow Measurement (TTFM) improves coronary artery bypass grafting (CABG) graft assessment. This method accurately identifies technical issues, leading to graft revisions and improved surgical outcomes in off-pump CABG procedures.

Area of Science:

  • Cardiovascular Surgery
  • Medical Devices
  • Surgical Techniques

Background:

  • Modern less invasive coronary artery bypass grafting (CABG) often omits heart-lung machines.
  • Achieving perfect anastomoses in beating heart surgery remains challenging.
  • Transit Time Flow Measurement (TTFM) is being assessed for evaluating beating heart CABG results.

Purpose of the Study:

  • To develop a standard algorithm for using and interpreting intraoperative TTFM.
  • To improve the accuracy of diagnosing technical problems in bypass grafts.
  • To enhance the quality of information from intraoperative flow measurements.

Main Methods:

  • 161 patients underwent off-pump CABG with 323 distal anastomoses between January and August 1998.
  • All grafts were tested intraoperatively using TTFM.

Related Experiment Videos

  • A decision nomogram with key TTFM values guided graft acceptance or revision.

    • Main Results:

    • 32 grafts (9.9%) were revised due to unsatisfactory flow curves or Pulsatile Index.
    • Revisions identified technical errors like intimal flaps, thrombus, kinking, or dissection.
    • No major complications, myocardial infarctions, or deaths occurred in the study cohort.

    Conclusions:

    • TTFM is strongly recommended for assessing graft patency in all CABG procedures, on or off pump.
    • Established guidelines for TTFM ensure high confidence in graft quality.
    • Simple TTFM parameters facilitate timely graft revision decisions for any flow concerns.