Publications

Objective: The purpose of this study is to evaluate the effect of detection of graft dysfunction by intraoperative transit time flow measurement (TTFM) on the surgical results of on-pump coronary artery bypass grafting. Methods: Two hundred patients undergoing on-pump isolate coronary artery bypass grafting via median sternotomy performed by the same surgical team were included into the study. TTFM was routinely performed for assessment of graft patency during operation after a transit time flow meter became available in our center in February 2006. The last 100 consecutive patients before this date formed the control group (Group A), and the first 100 consecutive patients after this date formed the study group (Group B). Interpretation of the values obtained using the TTFM in Group B patients has allowed us to reach a decision whether or not to revise a graft. Preoperative and postoperative variables of the two groups were compared.

Results: Read more...

Transit-time flowmetry enables immediate intraoperative assessment of blood flow parameters in coronary artery bypass grafts (CABG).
The present study assesses the predictive value of measured graft flows on early and medium-term outcomes. All cardiac surgery patients with measured graft flows were included. The last intraoperative flow measurements recorded using the Medtronic Butterfly Flowmetry system were used for analysis. Patients were separated into two groups: patients with normal flow in all grafts or patients with abnormal flow ≥ 1 graft. Any pulsatility index (pulsatility index=min-max flow/mean flow) ≤ 5 was determined to be normal flow. The study population included 985 patients. Read more...

Objective: This study was undertaken to evaluate transit-time flow (TTF) as a tool to detect technical errors in arterial bypass grafts intra-operatively and predict outcomes.
Methods: TTF’s three parameters, pulsatility index (PI, index of resistance), flow (cc min(-1)) and diastolic filling (DF, proportion of diastole with coronary flow), were measured in 990/1000 (99%) of arterial grafts in 336 consecutive patients, prospectively enrolled in a database. Grafts were revised when TTF findings supported the otherwise suspected graft malfunction. If no other signs/suspicion of graft malfunction existed (normal electrocardiogram (EKG), stable haemodynamics and unchanged ventricular function on trans-oesophageal echocardiography (TEE)), and the PI was >5, grafts were not revised. Major adverse cardiac events (MACEs: recurrent angina, perioperative myocardial infarction, postoperative angioplasty, re-operation and/or perioperative death) were related to TTF measurements.

Results: Read more...

Objective: Background: We have performed off-pump coronary artery bypass grafting (off-pump CABG; OPCAB) and also performed early postoperative angiography to assess anastomosis accuracy and patency in most of our patients requiring surgical revascularization.
Methods: Of 3083 patients who underwent isolated CABG between 1998 and 2017, 2919 patients (94.7%) underwent OPCAB. Conduits for distal anastomoses were left internal thoracic artery (ITA;n=2764), right ITA (n=866), right gastroepiploic artery (n=997), radial artery (n=16), and saphenous vein (n=1505). Since the introduction of transit-time flow measurement (TTFM) in 2000, we revised abnormal grafts intraoperatively. Early (≤7days) angiography was performed in 2820 patients (96.6%) at 1.5±1.2 postoperative days, and surgical intervention was performed based on angiographic findings.‍

Results: Read more...

Objectives: This study investigates the relationship between the use of transit time flow measurement (TTFM) and postoperative myocardial injury in off-pump coronary artery bypass grafting (OPCABG).Methods: In this retrospective study, we collected basic data from patients hospitalized for OPCABG in the Department of Cardiothoracic Surgery, Changzhou Second People’s Hospital Affiliated with Nanjing Medical University. According to the academic research consortium (ARC)-2 definition of significant myocardial injury, we used cardiac troponin I >2380 ng/L as a criterion for significant postoperative myocardial injury. We use logistic regression and forest plots to assess the association of TTFM use with myocardial injury outcomes.

Results: Read more...