Early graft patency is a major determinant of morbidity and mortality following coronary artery bypass surgery. Long-term graft failure is caused by intimal hyperplasia and atherosclerosis, while early failure, especially in the first year, has been attributed, in part, to surgical error. The need for intraoperative graft evaluation is paramount to determine need for revision and ensure future functioning grafts. Transit time flowmetry (TTFM) is the most commonly used intraoperative modality, however, only about 20% of cardiac surgeons in North America use TTFM. When combined with high resolution epicardial ultrasonography, TTFM provides high diagnostic yield. Fluorescence imaging can provide excellent visualization of the coronary and graft vasculature; however, data on this subject is limited. We herein examine the literature and discuss the available techniques for graft assessment along with their limitations.

Ohmes, L. B., Di Franco, A., Di Giammarco, G., Rosati, C. M., Lau, C., Girardi, L. N., Massetti, M., Gaudino, M., Techniques for intraoperative graft assessment in coronary artery bypass surgery, <<JOURNAL OF THORACIC DISEASE>>, 2017; 9 (Suppl 4): S327-S332. [doi:10.21037/jtd.2017.03.77] [http://hdl.handle.net/10807/110267]

Techniques for intraoperative graft assessment in coronary artery bypass surgery

Di Franco, Antonino;Massetti, Massimo;Gaudino, Mario
2017

Abstract

Early graft patency is a major determinant of morbidity and mortality following coronary artery bypass surgery. Long-term graft failure is caused by intimal hyperplasia and atherosclerosis, while early failure, especially in the first year, has been attributed, in part, to surgical error. The need for intraoperative graft evaluation is paramount to determine need for revision and ensure future functioning grafts. Transit time flowmetry (TTFM) is the most commonly used intraoperative modality, however, only about 20% of cardiac surgeons in North America use TTFM. When combined with high resolution epicardial ultrasonography, TTFM provides high diagnostic yield. Fluorescence imaging can provide excellent visualization of the coronary and graft vasculature; however, data on this subject is limited. We herein examine the literature and discuss the available techniques for graft assessment along with their limitations.
Inglese
Ohmes, L. B., Di Franco, A., Di Giammarco, G., Rosati, C. M., Lau, C., Girardi, L. N., Massetti, M., Gaudino, M., Techniques for intraoperative graft assessment in coronary artery bypass surgery, <<JOURNAL OF THORACIC DISEASE>>, 2017; 9 (Suppl 4): S327-S332. [doi:10.21037/jtd.2017.03.77] [http://hdl.handle.net/10807/110267]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/110267
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