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Role of Coronary Graft Flow Measurement During Reoperations for Early Graft Failure After Off‐Pump Coronary Revascularization
Author(s) -
Ricci Marco,
Karamanoukian Hratch L.,
Salerno Tomas A.,
D'Ancona Giuseppe,
Bergsland Jacob
Publication year - 1999
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.1999.tb01006.x
Subject(s) - medicine , hemodynamics , cardiology , revascularization , artery , cardiopulmonary bypass , surgery , bypass grafting , myocardial infarction
Doppler‐based techniques of coronary graft flow measurement are frequently used, especially during coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB), to exclude graft dysfunction resulting from technical errors. Nevertheless, early graft failure in the immediate postoperative period continues to affect a small percentage of patients who may require emergent reoperation as a result of severe hemodynamic deterioration. In this setting, in which coronary angiography is infrequently an option, expeditious intraoperative assessment of previously constructed coronary grafts may be performed by using the Doppler‐based technique Transit Time Flow Measurement (TTFM). As a result, the hemodynamic values obtained during reoperations may guide the operative strategy. In this study we report on eight patients who underwent “off‐pump” CABG and necessitated early reintervention as a result of presumed graft dysfunction. In these patients, graft dysfunction was confirmed or excluded by using intraoperatively the TTFM technique, comparing newly obtained flow hemodynamic variables with those recorded as a baseline during primary operations.