Transit-time flow technology is considered as a quality of care in bypass surgery especially in off pump revascularization. Transit time flow measurement is a real time, direct, easy and handy tool for assessment qual...Transit-time flow technology is considered as a quality of care in bypass surgery especially in off pump revascularization. Transit time flow measurement is a real time, direct, easy and handy tool for assessment quality of anastomosis and graft blood flow.展开更多
Objective: Vein graft quality control had been traditionally done for more than 20 years with a roller-pump flow measurement (RPFM) in our institute until off-pump coronary artery bypass grafting was introduced as the...Objective: Vein graft quality control had been traditionally done for more than 20 years with a roller-pump flow measurement (RPFM) in our institute until off-pump coronary artery bypass grafting was introduced as the standard technique of myocardial revascularization in the year 2009 in our institute. In this study, the RPFM method was compared with the Transit-time flow measurement (TTFM). Patients and Methods: From February to September 2005, 31 patients (5 females) undergoing CABG in our institute were included into the study. All the patients were operated with cardiopulmonary bypass. In those patients, 27 distal anastomoses were done with the left internal thoracic artery and 99 anastomoses were done with vein grafts. Those 99 vein graft were assessed both, with the RPFM method and TTFM method. Results: CABG could be safely performed in all cases. In all target vessels, the RPFM method overestimated bypass flow compared to the TTFM method, and simple linear regression revealed no correlation between the TTFM measurement and the RPFM measurement (r = 0.08, p = 0.21). There were two cases in which a graft problem could be detected only with TTFM method, even in our small patient cohort. Conclusion: The present study suggests that the TTFM method is clearly superior to the traditional RPFM method and we believe now that TTFM should be performed routinely in all CABG to improve patient care and quality of surgical results.展开更多
Compared with the open saphenous vein harvesting （OVH）, there is a larger decrease in inci-sion complications of endoscopic vein harvesting （EVH）. Fewer studies were conducted to evaluate the quality of great saph...Compared with the open saphenous vein harvesting （OVH）, there is a larger decrease in inci-sion complications of endoscopic vein harvesting （EVH）. Fewer studies were conducted to evaluate the quality of great saphenous vein （SVG） harvesting by these two methods. To apply transit time flow measurement （TTFM） to SVG grafts in coronary artery bypass grafting （CABG）, we properly evaluate the quality of SVG and surgical effect. Methods From January 2012 to August 2012, 38 cases underwent EVH and 16 cases underwent OVH. We recorded pulsatility index （PI）, mean graft flow （MGF） and diastolic flow （DF） of SVG grafts for statistical analysis. The dysfunctional grafts diagnostic criteria is PI 〉 5, MGF 〈 10 mL/min or DF 〈 50%. Result In terms of SVG grafts, no significant difference existed in the length of two groups （P = 0.2395）. EVH group har-vesting time was longer than OVH group （P = 0.0113）, but the incision length of EVH group was shorter （P = 0.0000） and it needed less suture time. EVH group presented no significant differences in incision complication rate from OVH group （P = 0.7055） within 1 month after surgery. TTFM data of well functioning grafts had no significant difference in the two groups （PI： 3.2 ± 1.0 vs. 2.9 ± 0.9, MGF： 34.7 ± 20.4 vs. 36.3 ± 19.2 mL / min, DF： 66.3% ± 10.6% vs. 68.5% ± 10.3%）. There was no significant difference in the rate of dysfunctional grafts in two groups （P = 0.7954） as well. The cause for tomosed the grafts with satisfactory effect. Conclusion vesting methods. The surgical effect and the quality of quality of SVG grafts can be reasonably evaluated by TYFM.展开更多
目的评估瞬时流量测定(transit time flow meter,TTFM)技术在冠状动脉旁路移植术(CABG)中探查移植血管血流通畅状态的应用价值,并分析其测定结果的相关因素。方法对我科2002年3月至2004年1月连续行CABG 301例患者的791支血管移植物进行T...目的评估瞬时流量测定(transit time flow meter,TTFM)技术在冠状动脉旁路移植术(CABG)中探查移植血管血流通畅状态的应用价值,并分析其测定结果的相关因素。方法对我科2002年3月至2004年1月连续行CABG 301例患者的791支血管移植物进行TTFM测定,按照入选标准从中筛选出左乳内动脉(LIMA)旁路移植到左前降支(LAD)的165例患者的TTFM结果,进行血流量和搏动指数(pulsatility index,PI)的多因素分析。结果TTFM技术提示,791支移植物中有严重质量问题的移植血管5支,均手术证实并加以改正。可能影响移植物血流量的主要因素为LAD远端直径、LIMA直径、心肌梗死位置、LAD近端狭窄程度、反流量百分比(percentage of insufficiency)、左心室舒张期末内径、手术方式(体外循环和非体外循环);影响PI值的主要因素为LAD远端直径、反流量百分比和手术方式。结论TTFM在判断CABG移植物状态时具有一定的诊断价值。多种因素均可影响移植物的血流量和PI值,应考虑主要影响因素以及临床表现来提高TTFM诊断技术错误的敏感性。展开更多
文摘Transit-time flow technology is considered as a quality of care in bypass surgery especially in off pump revascularization. Transit time flow measurement is a real time, direct, easy and handy tool for assessment quality of anastomosis and graft blood flow.
文摘Objective: Vein graft quality control had been traditionally done for more than 20 years with a roller-pump flow measurement (RPFM) in our institute until off-pump coronary artery bypass grafting was introduced as the standard technique of myocardial revascularization in the year 2009 in our institute. In this study, the RPFM method was compared with the Transit-time flow measurement (TTFM). Patients and Methods: From February to September 2005, 31 patients (5 females) undergoing CABG in our institute were included into the study. All the patients were operated with cardiopulmonary bypass. In those patients, 27 distal anastomoses were done with the left internal thoracic artery and 99 anastomoses were done with vein grafts. Those 99 vein graft were assessed both, with the RPFM method and TTFM method. Results: CABG could be safely performed in all cases. In all target vessels, the RPFM method overestimated bypass flow compared to the TTFM method, and simple linear regression revealed no correlation between the TTFM measurement and the RPFM measurement (r = 0.08, p = 0.21). There were two cases in which a graft problem could be detected only with TTFM method, even in our small patient cohort. Conclusion: The present study suggests that the TTFM method is clearly superior to the traditional RPFM method and we believe now that TTFM should be performed routinely in all CABG to improve patient care and quality of surgical results.
文摘Compared with the open saphenous vein harvesting （OVH）, there is a larger decrease in inci-sion complications of endoscopic vein harvesting （EVH）. Fewer studies were conducted to evaluate the quality of great saphenous vein （SVG） harvesting by these two methods. To apply transit time flow measurement （TTFM） to SVG grafts in coronary artery bypass grafting （CABG）, we properly evaluate the quality of SVG and surgical effect. Methods From January 2012 to August 2012, 38 cases underwent EVH and 16 cases underwent OVH. We recorded pulsatility index （PI）, mean graft flow （MGF） and diastolic flow （DF） of SVG grafts for statistical analysis. The dysfunctional grafts diagnostic criteria is PI 〉 5, MGF 〈 10 mL/min or DF 〈 50%. Result In terms of SVG grafts, no significant difference existed in the length of two groups （P = 0.2395）. EVH group har-vesting time was longer than OVH group （P = 0.0113）, but the incision length of EVH group was shorter （P = 0.0000） and it needed less suture time. EVH group presented no significant differences in incision complication rate from OVH group （P = 0.7055） within 1 month after surgery. TTFM data of well functioning grafts had no significant difference in the two groups （PI： 3.2 ± 1.0 vs. 2.9 ± 0.9, MGF： 34.7 ± 20.4 vs. 36.3 ± 19.2 mL / min, DF： 66.3% ± 10.6% vs. 68.5% ± 10.3%）. There was no significant difference in the rate of dysfunctional grafts in two groups （P = 0.7954） as well. The cause for tomosed the grafts with satisfactory effect. Conclusion vesting methods. The surgical effect and the quality of quality of SVG grafts can be reasonably evaluated by TYFM.
文摘目的评估瞬时流量测定(transit time flow meter,TTFM)技术在冠状动脉旁路移植术(CABG)中探查移植血管血流通畅状态的应用价值,并分析其测定结果的相关因素。方法对我科2002年3月至2004年1月连续行CABG 301例患者的791支血管移植物进行TTFM测定,按照入选标准从中筛选出左乳内动脉(LIMA)旁路移植到左前降支(LAD)的165例患者的TTFM结果,进行血流量和搏动指数(pulsatility index,PI)的多因素分析。结果TTFM技术提示,791支移植物中有严重质量问题的移植血管5支,均手术证实并加以改正。可能影响移植物血流量的主要因素为LAD远端直径、LIMA直径、心肌梗死位置、LAD近端狭窄程度、反流量百分比(percentage of insufficiency)、左心室舒张期末内径、手术方式(体外循环和非体外循环);影响PI值的主要因素为LAD远端直径、反流量百分比和手术方式。结论TTFM在判断CABG移植物状态时具有一定的诊断价值。多种因素均可影响移植物的血流量和PI值,应考虑主要影响因素以及临床表现来提高TTFM诊断技术错误的敏感性。
