Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
Ann Thorac Cardiovasc Surg. 2022 Aug 20;28(4):271-277. doi: 10.5761/atcs.oa.21-00255. Epub 2022 Apr 5.
Transit-time flow measurement (TTFM), consisting of pulsatility index (PI), mean graft flow, and diastolic filling, is mainly used as a bypass assessment for coronary artery disease (CAD). However, little was known about TTFM in the case of coronary malperfusion (CMP). This study aimed to clarify the difference in the results of TTFM between two different diseases.
Between 2010 and 2020, 138 patients underwent aortic surgery and coronary artery bypass grafting (CABG) with vein grafts. Patients were divided into two groups: CMP (n = 26) and CAD (n = 27). Their results were compared. The primary endpoints were the results of TTFM. Secondary endpoints were the relation between TTFM and mortality, morbidity, and short-term patency in each group.
The PI in the CMP group was significantly higher than the other group (4.7 ± 2.9 vs. 3.4 ± 1.9, p = 0.04). There was no statistical significance in the other two elements. In both groups, the short-term graft patency, mortality, and morbidity but for cardiac tamponade did not significantly change depending on the TTFM results.
Patients with CMP tended to have a higher PI than those with CAD. With additional CABG for aortic dissection, insufficient TTFM results did not necessarily mean poor short-term graft patency, complications, or case mortality.
经时流量测量（TTFM）由搏动指数（PI）、平均移植流量和舒张期充盈组成，主要用于评估冠状动脉疾病（CAD）的旁路。然而，对于冠状动脉灌注不良（CMP），对 TTFM 的了解甚少。本研究旨在阐明 TTFM 在两种不同疾病中的结果差异。
2010 年至 2020 年间，138 例患者接受了主动脉手术和冠状动脉旁路移植术（CABG），使用静脉移植物。患者分为两组：CMP（n=26）和 CAD（n=27）。比较两组结果。主要终点是 TTFM 的结果。次要终点是 TTFM 与每组死亡率、发病率和短期通畅性之间的关系。
CMP 组的 PI 明显高于其他组（4.7±2.9 对 3.4±1.9，p=0.04）。其他两个元素没有统计学意义。在两组中，短期移植物通畅率、死亡率和发病率，但心脏压塞除外，均不取决于 TTFM 结果而显著变化。
CMP 患者的 PI 倾向于高于 CAD 患者。对于主动脉夹层，额外的 CABG 治疗，TTFM 结果不佳并不一定意味着短期移植物通畅率差、并发症或病例死亡率高。
