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三种不同冠状动脉旁路移植术方法中桥血流流量计(瞬态流量测量)值的比较。

Comparison of flowmeter (transit time flow measurement) values for graft flow in three different surgical methods for isolated coronary artery bypass surgery.

机构信息

Cardiovascular Surgery Department, Faculty of Medicine, Ordu University, Ordu, Turkey. Email:

Cardivascular Surgery Department, Faculty of Medicine, Atatürk University, Erzurum, Turkey.

出版信息

Cardiovasc J Afr. 2023;34(4):242-247. doi: 10.5830/CVJA-2023-029. Epub 2023 Jul 4.

DOI:10.5830/CVJA-2023-029
PMID:37526962
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10870317/
Abstract

BACKGROUND

Graft patency is the most important factor in coronary artery bypass surgery. This study aimed to compare the relationship between three different surgical methods and transit time flow measurement (TTFM), which is used to detect technical problems in anastomoses performed during coronary artery bypass graft operations and to correct them if necessary.

METHODS

A total of 110 patients undergoing isolated coronary artery bypass surgery were analysed. Of these patients, 48 were operated on by inducing cardiopulmonary arrest (group 1), 33 were operated on without inducing cardiac arrest (group 2) during cardiopulmonary bypass surgery, and 29 underwent surgery on the off-pump beating heart (group 3). TTFMs were performed on all the patients' grafts. Additional surgical intervention requirements, the need for intra-operative and postoperative inotropic support, and all postoperative follow-up data were compared.

RESULTS

In total, 110 patients were measured for 301 grafts. Due to insufficient measurements performed on these patients, additional surgical intervention was performed on five grafts in group 1, five grafts in group 2, and seven grafts in group 3. These interventions enabled a normal flow rate to be achieved. The number of grafts that required revision was highest in group 3. There was no difference between the groups in terms of demographic data, EuroSCORE II, preoperative ejection fraction, postoperative complications and mortality rate.

CONCLUSION

TTFM is important for detecting technical problems in grafts. We believe that all surgical methods can be applied more safely by controlling graft flow.

摘要

背景

移植物通畅是冠状动脉旁路移植术最重要的因素。本研究旨在比较三种不同手术方法与即时时间流量测量(TTFM)之间的关系,TTFM 用于检测冠状动脉旁路移植术中吻合口的技术问题,并在必要时进行修正。

方法

分析了 110 例行单纯冠状动脉旁路移植术的患者。其中 48 例在心肺复苏(组 1)期间诱导心脏骤停进行手术,33 例在体外循环手术期间无心脏骤停(组 2)进行手术,29 例在非体外循环跳动心脏(组 3)下行手术。对所有患者的移植物进行 TTFM 检查。比较了所有患者的额外手术干预需求、术中及术后正性肌力支持的需要以及所有术后随访数据。

结果

总共对 110 例患者的 301 个移植物进行了测量。由于对这些患者的测量不足,在组 1 中有 5 个移植物、组 2 中有 5 个移植物和组 3 中有 7 个移植物进行了额外的手术干预。这些干预措施使流量恢复正常。需要进行修正的移植物数量在组 3 中最高。各组间在人口统计学数据、EuroSCORE II、术前射血分数、术后并发症和死亡率方面无差异。

结论

TTFM 对检测移植物的技术问题很重要。我们相信,通过控制移植物流量,可以更安全地应用所有手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc00/10870317/e15a968a3a82/cvja-34-243-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc00/10870317/e15a968a3a82/cvja-34-243-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc00/10870317/e15a968a3a82/cvja-34-243-g001.jpg

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