Related Experiment Video
Updated: May 8, 2025
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
CORRELATION BETWEEN EJECTION FRACTION AND CORONARY SINUS BLOOD FLOW DURING OFF-PUMP CORONARY ARTERY BYPASS GRAFTING
Ch Ejibishvili1, M Kiladze2, I Begashvili1
11Tbilisi 5th Clinical Hospital, Javakhishvili Tbilisi State University; 2Iv. Javakhishvili Tbilisi State University, American Hospital Tbilisi, Georgia.
Insights
Coronary artery bypass grafting (CABG) often increases coronary sinus blood flow (CSBF), but this change does not reliably predict improved cardiac function (ejection fraction). CSBF and ejection fraction showed no correlation post-CABG.
Area of Science:
- Cardiovascular Surgery
- Cardiac Physiology
Background:
- Coronary artery bypass grafting (CABG) improves patient survival.
- The impact of CABG on cardiac function remains debated.
Purpose of the Study:
- Assess coronary sinus blood flow (CSBF) as an intraoperative marker for adequate revascularization.
- Determine if myocardial function improves after revascularization.
- Correlate changes in CSBF with myocardial function changes.
Main Methods:
- Transesophageal echocardiography (TEE) used to measure ejection fraction (EF) and CSBF.
- Study included 70 adult patients undergoing off-pump CABG.
- Measurements taken before and after bypass grafting.
Main Results:
- CSBF increased in 74% of patients post-CABG.
- No reliable correlation was found between intraoperative CSBF and EF.
- Changes in CSBF did not reliably predict changes in EF.
Conclusions:
- CSBF typically increases after off-pump CABG.
- CSBF increase does not consistently correlate with improved ejection fraction post-revascularization.
Introduction:
Many studies have shown that coronary artery bypass grafting (CABG) increases the survival rate of patients, but the effect of bypass grafting on cardiac function is still a matter of debate.
Objective:
The objective of our study was to determine: a. To what extent can the change in coronary sinus flow be used as an intraoperative criterion for the assessment of adequate revascularization. b. Whether the functional improvement of the revascularized myocardium occurs. c. The existence of a correlation between the change in coronary sinus flow and changes in myocardial function.
Material And Methods:
Our study included 435 adult patients of both sexes, aged 55-85 years, ASA -III or less, who underwent coronary artery bypass grafting on a functioning heart. For this part of the study, 70 patients were selected, in whom ejection fraction (EF) and coronary sinus blood flow (CSBF) were determined before and after bypass grafting by transesophageal echocardiography (TEE).
Results:
CSBF flow in the CS increases in 74% of cases after bypass surgery, does not change in 9% of cases, and decreases in 17% of cases. Based on the results obtained, ΔFlow and ΔEF - this distribution is not reliable (Сhi2=2.76, p=0.599, NS) There is no reliable correlation between intraoperative CSBF and EF.
Conclusions:
In off-pump CABG-surgery, CSBF increases in most cases when assessed shortly after revascularization. In cases where an increase in EF was observed, CSBF did not increase in most cases and vice versa, meaning that CSBF and cardiac EF did not correlate in the immediate post-revascularization period.
More Related Videos
04:48Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
12:00Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
