Intraoperative coronary graft flow determination--does it have a prognostic value for midterm graft patency?
OBJECTIVE
To characterise the prognostic value of intraoperative ultrasonic graft flow determination during CABG for mid-term patency.


METHODS
From 01/2000 to 08/2003 3146 CABG procedures were performed at our institution. Graft flow was determined in all patients. Lumen diameter was given in mm and a sclerosis score was applied for the target vessel. 100 of these patients (3.2%) underwent postoperative coronary angiography at a mean time interval of 8.0 +/- 0.5 months.


RESULTS
In 100 patients, 114 LITA and 204 venous anastomoses were performed. At re-angiography 112 LITA (98%) and 174 venous (85%) anastomoses were patent. The amount of occluded LITA grafts was to low to perform statistical analyses. Mean graft flow of patent vein grafts was 48 +/- 2 ml/min vs. 32 +/- 4 ml/min in occluded vein grafts (p = 0.001). After multiple logistic regression analysis, only intraoperative vein graft flow was found to be a predictor for patency at mid-term (p = 0.005, odds ratio 0.97, 95% confidence interval (CI) from 0.95-0.99). No differences were found concerning sclerosis scores or vessel lumen between patent and occluded grafts.


CONCLUSIONS
Significant differences concerning intraoperative graft flow were found between vein grafts patent or occluded at re-angiography. The predictive power of intraoperative vein graft flow for mid-term patency was confirmed by multiple logistic regression analysis.
Cetin
S M
SM
Department of Thoracic and Cardiovascular Surgery, University Hospital, Hufelandstr. 55, D-45147 Essen, Germany.
Massoudy
P
P
Thielmann
M
M
Yildirim
C
C
Schmermund
A
A
Erbel
R
R
Jakob
H
H
D001783:Blood Flow Velocity / Q000502:physiology*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging* / Q000637:transplantation; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011379:Prognosis; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging* / Q000637:transplantation; D018608:Ultrasonography, Doppler; D014654:Vascular Patency / Q000502:physiology*