Cardiac Surgery
Perform cardiac imaging, measure blood flow and receive immediate feedback on how well a graft is functioning.
Intraoperative surgical guidance and quality assessment with ultrasonic imaging and blood flow measurement reduces risk of stroke for the patient. It also provides the surgeon with a tool to verify graft functionality, revise when needed and optimize the graft strategy during surgery.
These benefits are displayed in the first study to combine TTFM and High Frequency Ultrasound Imaging - the REQUEST Study.
Combining epicardial ultrasound imaging and TTFM enables the surgeon to perform a prompt and accurate revision of the graft.
Technical imperfections of an anastomosis can be immediately corrected in the operating room. Read more about the REQUEST study here.
Epiaortic imaging provides a sensitive and direct diagnosis of aortic disease. Evaluation of the ascending aorta prior to any manipulation may lead to modifications of the surgical strategy and thus contribute towards reduced rates of major adverse cardiac and cerebrovascular events (MACCE).
Publication
Link
Guidelines overview
Ethan S Rosenfeld, Gregory D Trachiotis, Andrew D Sparks, Michael A Napolitano, K. Benjamin Lee, Daniel Wendt, Teresa M Kieser, John D Puskas, Gabriele DiGiammarco, David P Taggart (2021), European Journal of Cardio-Thoracic Surgery
Intraoperative surgical strategy changes in patients with chronic and end-stage renal disease undergoing coronary artery bypass grafting
Intraoperative surgical strategy changes in patients with chronic and end-stage renal disease undergoing coronary artery bypass grafting
Taggart DP, Thuijs DJFM, Di GIammarco G, Puskas JD, Wendt D, Trachiotis GD, Kieser TM, Kappetein AP and Head SJ. (2020) , The Journal of Thoracic and Cardiovascular Surgery:
Intraoperative TTFM and HFUS Assessment in CABG - REQUEST
Intraoperative TTFM and HFUS Assessment in CABG - REQUEST
Kim K-B, Choi JW, Oh SJ, Hwang HY, Kim SJ, Choi J-S and Lim C (2020), The Annals of Thoracic Surgery:
Twenty-year experience with off-pump coronary artery bypass grafting and early postoperative angiography
Twenty-year experience with off-pump coronary artery bypass grafting and early postoperative angiography
Di Giammarco G and Marinelli D (2018), Indian Journal of Thoracic Cardiovascular Surgery:
Intraoperative graft assessment and imaging of native coronary vessels
Intraoperative graft assessment and imaging of native coronary vessels
Kaya U, Colak A, Becit N, Ceviz M and Kocak H. (2018). , Turkish Journal of Thoracic and Cardiovascular Surgery:
Intraoperative transit time flow measurement in on-pump coronary artery bypass graft surgery: Single center experience
Intraoperative transit time flow measurement in on-pump coronary artery bypass graft surgery: Single center experience
Taggart DP and Kieser TM (2018), Journal of Cardiac Surgery:
Current status of intra-operative graft assessment: Should it be the standard of care for coronary artery bypass graft surgery?
Current status of intra-operative graft assessment: Should it be the standard of care for coronary artery bypass graft surgery?
Di Giammarco, G., Marinelli D, Foschi M and Di Mauro M (2017), Journal of cardiovascular Medicine:
Intraoperative graft verification in coronary surgery
Intraoperative graft verification in coronary surgery
Kieser TM (2017), Current Opinion in Cardiology:
Graft quality verification in coronary artery bypass graft surgery: how, when and why?
Graft quality verification in coronary artery bypass graft surgery: how, when and why?
Amin S and Pincho-Gomes A-C (2016), Annals of Thoracic Surgery:
Relationship of Intraoperative Transit Time Flow Measurement to Angiographic Graft Patency at Follow-up
Relationship of Intraoperative Transit Time Flow Measurement to Angiographic Graft Patency at Follow-up
Lobo HG Filho, Lobo JG Filho, Silva BG, deSouza CS, Montenegro ML, de Azevedo Leitao MC and Jamacuru FV (2016), Brazilian Journal of Cardiovascular Surgery:
Intraoperative Analysis of Flow Dynamics in Arteriovenous Composite Y Grafts
Intraoperative Analysis of Flow Dynamics in Arteriovenous Composite Y Grafts
Oshima H, Tokuda Y, Araki Y, Ishii H, Murohara T, Ozaki Y and Usui A (2016), Interactive CardioVascular and Thoracic Surgery:
Predictors of Early Graft Failure After Coronary Artery Bypass Grafting for Chronic Total Occlusion
Predictors of Early Graft Failure After Coronary Artery Bypass Grafting for Chronic Total Occlusion
Banjanovic B, Bergsland J, Mujanovic E and Kabil E (2015), Innovations:
Importance of Full-Length Scan of Arterial Grafts in Coronary Artery Bypass Grafting
Importance of Full-Length Scan of Arterial Grafts in Coronary Artery Bypass Grafting
Watanabe T, Arai H, Oi K, Hachimaru T, Kuroki H, Fujiwara T and Mizuno T (2013), Circulation:
Detection of Internal Thoracic Artery Dissection at Coronary Anastomosis Using Intraoperative 15 Mhz High-Frequency Epicardial Ultrasound
Detection of Internal Thoracic Artery Dissection at Coronary Anastomosis Using Intraoperative 15 Mhz High-Frequency Epicardial Ultrasound
Hayakawa M, Asai T, Kinoshita T, and Shiraishi S (2013), Innovations:
Target Vessel Detection by Epicardial Ultrasound in Off-Pump Coronary Bypass Grafting
Target Vessel Detection by Epicardial Ultrasound in Off-Pump Coronary Bypass Grafting
Kamler M, Tossios P, Thielmann M, Wendt D, Osswald B and Jacob H (2010), Society for Thoracic and Cardiovascular Surgery:
Intraoperative epiaortic ultrasonography to guide the surgical approach
Intraoperative epiaortic ultrasonography to guide the surgical approach
Kieser TM, Rose S, Kowalewski R and Belenkie I (2010), Journal of Cardio-thoracic Surgery:
Transit-time flow predicts outcomes in coronary artery bypass graft patients: a series of 1000 consecutive arterial grafts
Transit-time flow predicts outcomes in coronary artery bypass graft patients: a series of 1000 consecutive arterial grafts
Nordgaard HB, Vitale N, Astudillo R, Renzulli A, Romundstad P and Haaverstad R (2010), European Journal of Cardio-thoracic Surgery:
Pulsatility index variations using two different transit-time flowmeters in coronary artery bypass surgery
Pulsatility index variations using two different transit-time flowmeters in coronary artery bypass surgery
Herman C, Sullivan JA, Buth K and Legare J-F (2008), Interactive CardioVascular and Thoracic Surgery:
Intraoperative graft flow measurements during coronary artery bypass surgery predict in-hospital outcomes
Intraoperative graft flow measurements during coronary artery bypass surgery predict in-hospital outcomes
Becit N, Erkut B, Ceviz M, Unlu Y, Colak A and Kocak H (2007), European Journal of Cardiothoracic Surgery:
The impact of intraoperative transit time flow measurement on the results of on-pump coronary surgery
The impact of intraoperative transit time flow measurement on the results of on-pump coronary surgery
Bauer SF, Bauer K, Ennker C, Rosendahl U and Ennker J (2005), Thoracic Cardiac Surgeon:
Intraoperative Bypass Flow Measurement Reduces the Incidence of Post-operative Ventricular Fibrillation and Myocardial Markers After Coronary Revascularization
Intraoperative Bypass Flow Measurement Reduces the Incidence of Post-operative Ventricular Fibrillation and Myocardial Markers After Coronary Revascularization
D'Ancona G, Karamanoukian HL, Ricci HL, Schmid S, Bergsland J and Salerno TA (2000), European Journal of Cardiothoracic Surgery:
Graft Revision after transit time flow measurement in off-pump coronary artery bypass grafting
Graft Revision after transit time flow measurement in off-pump coronary artery bypass grafting
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