The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) recommend graft assessment by TTFM and epiaortic HFUS prior to manipulation. “Transit-time flow measurement is the most frequently used technique for graft assessment and has been able to detect 2 - 4% of grafts that require revision. In observational studies, the use of intraoperative graft assessment has been shown to reduce the rate of adverse events and graft failure, although interpretation can be challenging in sequential and T-graft configurations.”
Recommendations
TTFM:
Routine intraoperative graft flow measurement should be considered.
Recommendation class IIa
Evidence level B
HFUS:
Epiaortic scanning should be considered prior to aortic manipulation.
Recommendation class IIa
Evidence level C
