Comparison between OPCABG and CABG Surgical Revascularization Using Transit Time Flow Measurement (TTFM)

Area of Science:

• Cardiovascular Surgery
• Surgical Technology
• Hemodynamics

Background:

• Coronary artery bypass grafting (CABG) is a standard treatment for coronary artery disease.
• Assessing the quality of coronary anastomoses is crucial for long-term graft patency and patient outcomes.
• Cardiopulmonary bypass (CPB) versus off-pump CABG (OPCABG) techniques have different implications for intraoperative assessment.

Purpose of the Study:

• To compare the intraoperative quality of coronary anastomoses performed with or without cardiopulmonary bypass.
• To evaluate the utility of transit-time flow measurement (TTFM) parameters in assessing anastomosis quality in both CABG and OPCABG procedures.

Main Methods:

• Retrospective review of 588 consecutive patients undergoing surgical revascularization.
• Data collected from 411 patients in the CABG group and 177 patients in the OPCABG group.
• Transit-time flow measurement parameters, including mean graft flow (MGF), pulsatile index (PI), and diastolic filling (DF), were measured for each graft.

Main Results:

• Patients in the OPCABG group had a higher EuroSCORE compared to the CABG group (3.53 ± 2.32 vs. 2.84 ± 2.15, P = .002).
• No statistical difference in overall TTFM parameters between CABG and OPCABG.
• A higher pulsatile index (PI) was observed in the OPCABG group in the circumflex artery territory for all graft types (3.0 ± 4.9 vs. 2.4 ± 2.0, P = .026).

Conclusions:

• Both CABG and OPCABG techniques demonstrated comparable intraoperative anastomosis quality based on TTFM parameters.
• Higher PI in OPCABG in specific territories suggests potential differences in flow dynamics.
• Routine use of transit-time flow measurement may enhance the quality, safety, and efficacy of coronary artery bypass grafting.