左胸廓内动脉至左前降支动脉搭桥的血流测定：体外循环与非体外循环手术的比较

Flowmetry of left internal thoracic artery graft to left anterior descending artery: comparison between on-pump and off-pump surgery.

作者信息

Cerqueira Neto Filinto Marques de, Guedes Marco Antonio Vieira, Soares Leonardo Eugênio Fonseca, Almeida Gustavo Santiago, Guimarães André Raimundo F, Barreto Mauricio Alves, Porto Emerson Costa, Rabelo Júnior Alvaro

机构信息

SBCCV, Salvador, BA, Brasil.

出版信息

Rev Bras Cir Cardiovasc. 2012 Apr-Jun;27(2):283-9. doi: 10.5935/1678-9741.20120045.

DOI:10.5935/1678-9741.20120045

PMID:22996980

Abstract

BACKGROUND

Off-pump coronary bypass grafting (OPCAB) has become a widely used technique. Coronary flowmetry is the most common method employed to assess graft patency, nevertheless, few studies compare flow patterns between ONCAB and OPCAB surgery. The objective of this study was to compare flowmetry data in left internal mammary artery grafts bypasses to the left anterior descendent artery.

METHODS

From March to September of 2010, thirtyfive consecutive, non-randomized patients underwent CABG and were retrospectively evaluated. Ten patients were located on group A (On Pump), and twenty-five on group B (Off Pump). The mean graft flow (MGF), pulsatile index (PI) and diastolic filling (DF) were obtained using Transit Time Flowmetry (TTFM). The Fisher exact test, and Mann Whitney test were used, and a P value of < 0.05 was considered to indicate statistical significance.

RESULTS

There were no deaths, AMI, re-interventions or PTCA in a 30-day period. The number of bypasses performed per patient was 2.3 ± 0.8 in the OPCAB group, and 2.2 ± 0.6 in the ONCAB group, with no significant difference (P=0.10). The median of mean flow was 23 ml/min on group A, and 25 ml/min on group B (P=0.34). Diastolic filling percentage was 56% on group A, and 56.9% on group B (P=0.86). Pulsatile Index was 2.3 on group A, and 2.2 on group B (P=0.82).

CONCLUSIONS

There was no difference between TTFM values (MF, PI and DF) in patients operated with or without cardiopulmonary bypass.

摘要

背景

非体外循环冠状动脉旁路移植术（OPCAB）已成为一种广泛应用的技术。冠状动脉血流测定是评估移植血管通畅性最常用的方法，然而，很少有研究比较体外循环冠状动脉旁路移植术（ONCAB）和非体外循环冠状动脉旁路移植术手术之间的血流模式。本研究的目的是比较左乳内动脉移植至左前降支动脉的血流测定数据。

方法

2010年3月至9月，连续35例非随机患者接受冠状动脉旁路移植术并进行回顾性评估。10例患者归入A组（体外循环），25例归入B组（非体外循环）。使用渡越时间血流测定法（TTFM）获得平均移植血管血流（MGF）、搏动指数（PI）和舒张期充盈（DF）。采用Fisher精确检验和Mann-Whitney检验，P值<0.05被认为具有统计学意义。

结果

30天内无死亡、急性心肌梗死、再次干预或经皮冠状动脉腔内血管成形术（PTCA）发生。OPCAB组每位患者进行的旁路移植数量为2.3±0.8，ONCAB组为2.2±0.6，无显著差异（P=0.10）。A组平均血流中位数为23 ml/min，B组为25 ml/min（P=0.34）。A组舒张期充盈百分比为56%，B组为56.9%（P=0.86）。A组搏动指数为2.3，B组为2.2（P=0.82）。