ArticleJournal of cardiovascular and thoracic research2025
Intraoperative transit time flowmetry during off-pump coronary artery bypass grafting: Early outcome of two different anastomosis technique.
Article in Journal of cardiovascular and thoracic research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Intraoperative transit time flowmetry (TTF) is an essential technique for evaluating graft function during off-pump coronary artery bypass grafting (OPCABG). This study compares graft quality and outcomes using TTF in two surgical approaches: sequential and Y-type saphenous vein grafting. Methods: A total of 120 patients with triple-vessel coronary artery disease were enrolled and randomized into two groups: Group 1 (n=60) received sequential grafts; Group 2 (n=60) received Y-grafts. Mean graft flow (MGF) and pulsatility index (PI) were measured intraoperatively. Graft function was classified based on flow>15 ml/min and PI<2.5. All patients underwent coronary CT angiography at 48 months to assess graft patency. Results: Intraoperative TTF showed no significant difference in MGF or PI between graft types, although sequential grafts demonstrated slightly higher flow and lower resistance. Intraoperative graft failure occurred in 1.7% (sequential) vs. 3.3% (Y-grafts). At 48-month follow-up, sequential grafts showed 100% patency, while Y-grafts had a 7.0% occlusion rate. Multivariate analysis identified vessel diameter and conduit type as significant predictors of graft performance; graft configuration (sequential vs. Y) was not independently predictive. Conclusion: TTF is a valuable intraoperative tool for ensuring graft functionality in OPCABG. While both techniques are viable, sequential grafting demonstrated superior mid-term patency and lower failure rates. These findings support the preferential use of sequential grafting when anatomically feasible and highlight the importance of routine TTF to optimize surgical outcomes.
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