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Non Invasive Detection of Coronary Sinus Flow Changes Over Time After CABG
Bedrudin Banjanovic1, Ilirijana Haxhibeqiri Karabic1, Slavenka Straus1
1Clinic for Cardiovascular Surgery, Clinical Center University of Sarajevo, Bosnia and Herzegovina.
Insights
New blood flow in the coronary arteries significantly increased after Coronary Artery Bypass Grafting (CABG), improving tissue nutrition. This blood flow continued to rise steadily in the first six days post-surgery.
Area of Science:
- Cardiovascular Research
- Surgical Outcomes
- Hemodynamics
Background:
- New blood supply in the coronary vascular bed post-Coronary Artery Bypass Grafting (CABG) is crucial for transitioning from ischemia to normal tissue perfusion.
- Quantifying this neovascularization aids in understanding coronary hemodynamics after revascularization procedures.
Purpose of the Study:
- To quantify changes in coronary sinus blood flow over time following Coronary Artery Bypass Grafting (CABG) using Transthoracic Echocardiography (TTE).
Main Methods:
- Prospective study involving 61 patients undergoing CABG, with Transthoracic Echocardiography (TTE) measurements of coronary sinus (CS) flow, diameter, and Velocity Time Integral (VTI) taken preoperatively and on postoperative days 1 and 6.
- Systemic hemodynamic data and left ventricular (LV) mass parameters were also recorded.
- Statistical analysis utilized ANOVA for Repeated Measures with a significance level of α = 0.01 and power of 99%.
Main Results:
- Preoperative mean CS flow was 181 ±72 ml/min, increasing to 276 ±79 ml/min on postoperative day 1 and 355 ±99 ml/min on postoperative day 6.
- The increase in CS flow was statistically significant (P<0.001) after CABG.
- The highest neovascularization was observed in patients receiving four bypass grafts.
Conclusions:
- Coronary Artery Bypass Grafting (CABG) leads to a significant increase in coronary blood supply.
- A continuous rise in coronary blood flow was observed in the initial six days following CABG.
Background:
Coronary New blood in the vascular bed after Coronary Artery Bypass Grafting (CABG) may represent a turning point between ischemia and normal tissue nutrition. Its quantification can help to better understand coronary artery hemodynamics after revascularization.
Objective:
Quantification of coronary sinus blood flow changes over time after Coronary Artery Bypass Grafting (CABG) using Transthoracic Echocardiography (TTE).
Methods:
Prospective basic research, with repeated measurements on hospital sample of 61 patients whom CABG was conducted. We performed TTE recordings to measure CS flow before and two times after CABG (1 and 6 postoperative day). We measure CS diameter, Velocity Time Integral (VTI) and systemic hemodynamic data. Data needed for LV mass calculation were recorded once. During statistical analysis we define: α = 0,01, β = 0,01 (power = 1-β β= 0,99), Sample size = 60, Effect size= 0,68. We used ANOVA for Repeated Measures as main statistical test in SPSS.
Results:
Preoperatively we found low overall CS flow of 181 ±72 ml/min (0,68 ±0,30 ml/gram-LV/min). After surgery there was constant increase of CS flow from 276 ±79 ml/min (1,13 ±0,35 ml/gram-LV/min) first postoperative day, to 355 (±99) ml/min (1,30 ±0,46 ml/gram-LV/min) sixth postoperative day.
Discussion:
Amount of new blood was statistically significant after CABG with P<0,001. Same result was found after classifying patients per number of graft received, with the highest amount of new blood after four bypasses. Amount of new blood was not different if patient gets two or three bypasses.
Conclusion:
There was significantly new amount of blood in coronary bed after CABG, with constant increase over first 6 days.
