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Transit Time Flowmetry in Coronary Artery Bypass Grafting-experience at Queen Alia Heart Institute, Jordan
1Consultant Cardiac Surgeon, Prince Hamzeh suburb, P.O. Box 134 Jordan 11733.
Insights
Transit time flowmetry (TTF) in coronary artery bypass grafting (CABG) showed that grafts to the left anterior descending (LAD) artery had the best flow. Some suboptimal grafts were revised, improving outcomes.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Surgical Technology
Background:
- Coronary artery bypass grafting (CABG) is a critical procedure for treating coronary artery disease.
- Ensuring optimal graft flow is essential for long-term graft patency and patient outcomes.
- Transit time flowmetry (TTF) is an intraoperative tool used to assess graft performance.
Purpose of the Study:
- To evaluate the effectiveness of transit time flowmetry (TTF) in assessing coronary artery bypass grafting (CABG) outcomes.
- To analyze graft flow patterns and identify suboptimal grafts in a consecutive patient cohort.
- To determine the incidence of graft revisions based on TTF results.
Main Methods:
- Intraoperative flow measurements were performed on 436 consecutive CABG patients.
- Assessed mean flows and pulsatility index (PI) for each coronary artery system.
- Identified grafts with inadequate flowmetry results requiring potential revision.
Main Results:
- 1394 grafts were assessed, with 7.2% showing inadequate flowmetry.
- Grafts to the left anterior descending (LAD) artery had the lowest rate of inadequate flow (4.4%) and optimal mean flow (33.4±5.3 mL/min, PI 2.4±0.4).
- Grafts to the circumflex and right coronary arteries had higher rates of inadequate flow (9.4%) and different flow characteristics.
Conclusions:
- Grafts to the LAD system demonstrated superior flowmetry results compared to those supplying the circumflex and right coronary arteries.
- TTF successfully identified suboptimal grafts, leading to revisions in a small percentage of cases (1.1%).
- TTF is a valuable tool for intraoperative assessment and optimization of CABG graft performance.
Objectives:
To assess the results of transit time flowmetry (TTF) on a consecutive group of coronary artery bypass grafting (CABG) patients at Queen Alia Heart Institute.
Methods:
Intraoperative flow measurements of a consecutive group of 436 CABG patients. The flow pattern for each coronary artery system was assessed including mean flows, pulsatility index (PI) and the need for revision.
Results:
A total of 1394 grafts in 436 patients were assessed (3.2 grafts per patient), wherein 100 grafts showed inadequate flowmetry results (7.2%); most of which were in the circumflex and right coronary artery systems with a percentage of 9.4% and the least in the LAD system with a percentage of 4.4%. The mean flow of grafts to the LAD system was 33.4±5.3 mL/min with a PI of 2.4±0.4; while the mean for grafts to the circumflex artery system was 35.1±7.2 mL/min with a PI of 3.5±0.7. The mean for the right coronary artery was 38.4±5.9 mL/min with a PI of 2.6±0.6. Revisions occurred in five patients (1.1%). Suboptimal grafts to the LAD system exhibited a flow of 14.1±7.4 mL/min with a PI of 6.9±1.7. While for the circumflex system a flow of 5.5±3.6 mL/min was reported with a PI of 10.4±7.8; and for the right coronary system a flow of 7.2±5.3 mL/min with a PI of 9.1±5.7 was reported.
Conclusion:
Grafts to the LAD system showed the best flowmetry results compared to grafts to the circumflex and right coronary systems. A proportion of poor grafts were revised.
