title: Pulsed Doppler intraoperative flow assessment and midterm coronary graft patency.
abstract: BACKGROUND
  This study was designed to assess the value of hemodynamic measurements taken intraoperatively in predicting midterm patency of coronary bypass grafts.
  
  
  METHODS
  A pulsed Doppler flowmeter was routinely used during operation to determine the hemodynamic parameters of coronary bypass grafts. During a 7-year period, 85 patients underwent angiographic evaluation. As a result, a thorough hemodynamic assessment of 214 grafts (89 arterial and 125 venous) at initial operation was available for analysis.
  
  
  RESULTS
  The overall patency rate was 88.3%. The mean flow measured intraoperatively in 168 intact grafts was 60+/-3 mL/min (range, 9 to 230 mL/min), and the resistance was 1.8+/-0.1 peripheral resistance units (range, 0.3 to 9.0 peripheral resistance units). The mean flow was 36+/-5 mL/min (range, 2 to 107 mL/min), and the resistance was 5.9+/-2.0 peripheral resistance units (range, 0.6 to 46.0 peripheral resistance units) in 25 grafts found occluded at angiographic evaluation. Multivariate analysis identified three independent variables associated with a reduced patency rate: increased resistance as measured in the graft (p = 0.012), increasing interval of control angiography (p = 0.006), and preoperative cardiogenic shock (p = 0.040).
  
  
  CONCLUSIONS
  The prognosis for midterm patency of aortocoronary bypass grafts depends on the intraoperative hemodynamic status.
authors.affiliation: Unit of Cardiovascular and Thoracic Surgery, University Hospital of Mont-Godinne, Catholic University of Louvain, Yvoir, Belgium.
authors.forename: Y A
authors.initials: YA
authors.lastname: Louagie
authors.forename: C E
authors.initials: CE
authors.lastname: Brockmann
authors.forename: J
authors.initials: J
authors.lastname: Jamart
authors.forename: E
authors.initials: E
authors.lastname: Schroeder
authors.forename: M
authors.initials: M
authors.lastname: Buche
authors.forename: P M
authors.initials: PM
authors.lastname: Eucher
authors.forename: J C
authors.initials: JC
authors.lastname: Schoevaerdts
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018608:Ultrasonography, Doppler; D014654:Vascular Patency / Q000502:physiology