The application of intraoperative transit time flow measurement to accurately assess anastomotic quality in sequential vein grafting

作者：Yang Yu, Fan Zhang, Mingxin Gao, Haitao Li, Jingxing Li, Wei Song, Xinsheng Huang, Chengxiong Gu · 发表于：Interactive Cardiovascular and Thoracic Surgery · 年份：2013 · DOI：10.1093/icvts/ivt398 · 被引用次数：9 · 研究领域：Cardiac and Coronary Surgery Techniques、Coronary Interventions and Diagnostics、Pancreatic and Hepatic Oncology Research

OBJECTIVES: Intraoperative transit time flow measurement (TTFM) is widely used to assess anastomotic quality in coronary artery bypass grafting (CABG). However, in sequential vein grafting, the flow characteristics collected by the conventional TTFM method are usually associated with total graft flow and might not accurately indicate the quality of every distal anastomosis in a sequential graft. The purpose of our study was to examine a new TTFM method that could assess the quality of each distal anastomosis in a sequential graft more reliably than the conventional TTFM approach. METHODS: Two TTFM methods were tested in 84 patients who underwent sequential saphenous off-pump CABG in Beijing An Zhen Hospital between April and August 2012. In the conventional TTFM method, normal blood flow in the sequential graft was maintained during the measurement, and the flow probe was placed a few centimetres above the anastomosis to be evaluated. In the new method, blood flow in the sequential graft was temporarily reduced during the measurement by placing an atraumatic bulldog clamp at the graft a few centimetres distal to the anastomosis to be evaluated, while the position of the flow probe remained the same as in the conventional method. This new TTFM method was named the flow reduction TTFM. Graft flow parameters measured by both methods were compared. RESULTS: Compared with the conventional TTFM, the flow reduction TTFM resulted in significantly lower mean graft blood flow (P < 0.05...