Yenigün Orhun Abdulgani, Mirizada Miri, Çidem Savaş, Dikkaş Uğur, Tel Üstünışık Çiğdem, Arapi Berk, Balkanay Ozan Onur, Göksedef Deniz, Ömeroğlu Suat Nail, İpek Gökhan
Department of Cardiovascular Surgery, İstanbul University of Cerrahpaşa-Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Dec 31;32(4 Suppl 2):086-86. doi: 10.5606/tgkdc.dergisi.2024.msb-62. eCollection 2024 Nov.
This study aimed to compare the efficacy of the bidirectional palpation test and the results of transit time flow meter (TTFM) measurements by examining graft patency through early-period coronary computed tomography angiography.
The study was designed as a retrospective-prospective hybrid cohort study. Graft patency in the left internal mammary artery (LIMA) to left anterior descending artery anastomosis of 73 patients was evaluated. The results of the bidirectional palpation test and TTFM measurements performed during coronary artery bypass grafting were compared with contrast-enhanced coronary computed tomography angiography performed in the early postoperative period.
Graft patency was statistically significantly higher in patients with a positive bidirectional palpation test compared to those with a negative test (p<0.001). Similarly, graft patency was significantly higher in patients with a mean flow of 10 mL/min or more compared to those with a mean flow below 10 mL/min (p=0.001).
A significant positive correlation was revealed between the bidirectional palpation test and the mean flow measured by TTFM. Additionally, both the bidirectional palpation test and TTFM accurately demonstrated the intraoperative LIMA graft patency. These findings indicate that both tests can be reliably used in the assessment of the LIMA to left anterior descending artery anastomosis.
本研究旨在通过早期冠状动脉计算机断层扫描血管造影术检查移植物通畅情况，比较双向触诊试验的疗效与 transit time flow meter（TTFM）测量结果。
本研究设计为回顾性-前瞻性混合队列研究。评估了73例患者左乳内动脉（LIMA）至左前降支动脉吻合处的移植物通畅情况。将冠状动脉搭桥术中进行的双向触诊试验和TTFM测量结果与术后早期进行的对比增强冠状动脉计算机断层扫描血管造影结果进行比较。
双向触诊试验阳性的患者移植物通畅率在统计学上显著高于试验阴性的患者（p<0.001）。同样，平均血流量为10 mL/min或更高的患者移植物通畅率显著高于平均血流量低于10 mL/min的患者（p=0.001）。
双向触诊试验与TTFM测量的平均血流量之间存在显著正相关。此外，双向触诊试验和TTFM均准确显示了术中LIMA移植物的通畅情况。这些发现表明，这两种试验均可可靠地用于评估LIMA至左前降支动脉的吻合情况。
