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
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DOI：
10.1016/j.ejcts.2010.01.026
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发表时间：
2010-08-01
影响因子：
3.4
通讯作者：
Betenkie, Israel
中科院分区：
文献类型：
--
作者：
Kieser, Teresa Mary;Rose, Sarah;Betenkie, Israel
目的：本研究旨在评价通过时间血流（TTF）作为术中检测动脉旁路移植术技术错误和预测结局的工具。研究方法：TTF的三个参数，搏动指数（PI，阻力指数），流量（cc min（-1））和舒张期充盈（DF，冠状动脉血流中胆固醇的比例），在990/1000（99%）的动脉移植在336例连续患者中进行了测量，前瞻性纳入数据库。当TTF结果支持其他疑似移植物故障时，对移植物进行翻修。如果不存在移植物故障的其他体征/怀疑（心电图（EKG）正常，经食管超声心动图（TEE）显示血流动力学稳定和心室功能不变），并且PI>5，则不对移植物进行翻修。主要不良心脏事件（MACES：复发性心绞痛、围手术期心肌梗死、术后血管成形术、再次手术和/或围手术期死亡）与TTF测量相关。结果：平均每例患者移植血管3.02支，其中动脉占99%。916/990（93%）的移植物获得了满意的移植物，流量为34至61 cc min（-1），PI 5（5/54，9%），而PI患者
Objective: This study was undertaken to evaluate transit-time flow (TTF) as a tool to detect technical errors in arterial bypass grafts intraoperatively 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: The average number of grafts per patient was 3.02, of which 99% were arterial. Satisfactory grafts were achieved in 916/990 (93%) of the grafts, with flows from 34 to 61 cc min(-1), PI 5 (5/54, 9%) than in patients with a PI