Original articleCardiovascularTransit-Time Flow Measurement is Essential in Coronary Artery Bypass Grafting
Section snippets
Patients and Methods
From January 1, 2001, to June 30, 2002, 116 patients underwent primary isolated CABG within a single surgical service. Sixty-seven patients (58%) underwent conventional CABG, and 49 (42%) underwent off-pump CABG. There were 84 men and 32 women, of which there were 17 Malays, 11 Indians, 85 Chinese, and 3 Eurasians. Mean age was 60.7 ± 9.5 years, and mean body surface area was 1.69 ± 0.18 m2. There were 125 IMA grafts and 197 saphenous vein grafts (SVGs). The mean number of grafts was 2.9 per
Results
Of the 116 patients, 6 patients had seven grafts in which a high PI, low mean flow, unsatisfactory flow curve, or all of them were detected using the transit-time flowmeter. Problems included IMA that was occluded or stretched, or SVGs that were kinked, twisted, or stenosed at anastomotic sites. In all cases the problems were corrected at the time of surgery, resulting in satisfactory flows. When an unsatisfactory flow was observed in the vein graft, the graft was carefully inspected for the
Comment
Transit-time flow measurement gives important and accurate intraoperative information about the status and patency of each individual graft. It enables technical problems such as kinked, twisted, or stenotic grafts to be diagnosed accurately, thereby allowing prompt revision of the constructed grafts before the patient leaves the operating room. Thus, hemodynamic instability during the early postoperative period is possibly prevented and the probability of early graft failure is minimized
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