The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-4329
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2026
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Mukimov Sh.D.

National Medical Research Center of Cardiology

Zaikovskii V.Yu.

National Medical Research Center of Cardiology

Andreev A.V.

Regional Clinical Hospital No. 2;
Kuban State Medical University

Galyautdinov D.M.

Chazov National Medical Research Centre of Cardiology

Vlasova E.E.

National Medical Research Center of Cardiology

Vasiliev V.P.

Chazov National Medical Research Centre of Cardiology

Shiryaev A.A.

Chazov National Medical Research Centre of Cardiology

Impact of intraoperative flowmetry data on clinical and angiographic outcomes after coronary artery bypass grafting in patients with diffuse coronary atherosclerosis

Authors:

Mukimov Sh.D., Zaikovskii V.Yu., Andreev A.V., Galyautdinov D.M., Vlasova E.E., Vasiliev V.P., Shiryaev A.A.

More about the authors

Journal: Russian Cardiology Bulletin. 2021;16(4): 41‑48

DOI: 10.17116/Cardiobulletin20211604141

Read: 1503 times

Download PDF (RU)
Contact the author
Table of contents

IMPACT OF INTRAOPERATIVE FLOWMETRY DATA ON CLINICAL AND ANGIOGRAPHIC OUTCOMES AFTER CORONARY ARTERY BYPASS GRAFTING IN PATIENTS WITH DIFFUSE CORONARY ATHEROSCLEROSIS
IMPACT OF INTRAOPERATIVE FLOWMETRY DATA ON CLINICAL AND ANGIOGRAPHIC OUTCOMES AFTER CORONARY ARTERY BYPASS GRAFTING IN PATIENTS WITH DIFFUSE CORONARY ATHEROSCLEROSIS

To cite this article:

Mukimov ShD, Zaikovskii VYu, Andreev AV, Galyautdinov DM, Vlasova EE, Vasiliev VP, Shiryaev AA. Impact of intraoperative flowmetry data on clinical and angiographic outcomes after coronary artery bypass grafting in patients with diffuse coronary atherosclerosis. Russian Cardiology Bulletin. 2021;16(4):41‑48. (In Russ.)
https://doi.org/10.17116/Cardiobulletin20211604141

Подписка 2026 Кардиологический вестник (Russian Cardiology Bulletin)
МСФ на ЯМ
Использование инфографики авторами научных работ
Close metadata
Abstract:

OBJECTIVE

To evaluate the impact of transit-time flow measurement (TTFM) parameters on clinical and angiographic outcomes in patients with diffuse coronary atherosclerosis within 1 year after coronary artery bypass grafting (CABG).

MATERIAL AND METHODS

A prospective study included 150 patients after CABG with intraoperative flowmetry for the period 2018—2020. We analyzed pulsatility index (PI), diastolic filling (DF) and mean graft flow (MGF). All patients were divided in to 2 groups. The first group included patients with optimal flowmetry parameters (n=121); others formed the second group with suboptimal values of flowmetry (n=29). Follow-up data were collected by phone calls in 146 (97.3%) patients (118 and 28 ones in both groups, respectively). Recurrence of angina, myocardial infarction, repeated revascularization, all-cause mortality and angiography data in patients with verified angina were analyzed. The median follow-up was 15 (13; 18) months.

RESULTS

Clinical and demographic characteristics demonstrated significant difference in the incidence of diabetes mellitus (22.0% vs 42.9%, p=0.024). Coronary arteries of small diameter (≤1 mm) were more common in the 2nd group (18.3% vs 30.9%, p=0.007). In-hospital outcomes including 30-day mortality (0 vs 3.6%, p=0.192) were comparable. Angina recurrence was diagnosed in 17 patients (11.9%) in both group (9.5% vs 22.2%, p=0.065). Incidence of myocardial infarction (1.7% vs 3.7%) and repeated revascularization (6.0% vs 7.4%) were similar in both groups. Two patients died throughout the entire follow-up period. Causes of mortality were unclear. Angiography data demonstrated the main risk factors of graft dysfunction: suboptimal parameters of flowmetry (HR=4.3, 95% CI: 0.96—19.1, p=0.045) and coronary artery diameter <1 mm (HR=3.3, 95% CI: 0.9—12.2, p=0.06).

CONCLUSION

Suboptimal parameters of intraoperative flowmetry of ≥1 coronary grafts are associated with more severe coronary atherosclerosis and higher incidence of angina recurrence, as well graft dysfunction within 1 year after surgery.

Keywords:

coronary artery bypass grafting
intraoperative flowmetry
diffuse coronary atherosclerosis

Authors:

Mukimov Sh.D.

National Medical Research Center of Cardiology

Zaikovskii V.Yu.

National Medical Research Center of Cardiology

Andreev A.V.

Regional Clinical Hospital No. 2;
Kuban State Medical University

Galyautdinov D.M.

Chazov National Medical Research Centre of Cardiology

Vlasova E.E.

National Medical Research Center of Cardiology

Vasiliev V.P.

Chazov National Medical Research Centre of Cardiology

Shiryaev A.A.

Chazov National Medical Research Centre of Cardiology

Received:

12.10.2021

Accepted:

26.10.2021

Close metadata

References:

  1. Balacumaraswami L, Taggart DP. Intraoperative imaging techniques to assess coronary artery bypass graft patency. The Annals of Thoracic Surgery. 2007;83(6):2251-2257. https://doi.org/10.1016/j.athoracsur.2006.12.025
  2. Gaudino M, Antoniades C, Benedetto U, Deb S, Di Franco A, Di Giammarco G, Fremes S, Glineur D, Grau J, He GW, Marinelli D, Ohmes LB, Patrono C, Puskas J, Tranbaugh R, Girardi LN, Taggart DP, ATLANTIC (Arterial Grafting International Consortium) Alliance. Mechanisms, Consequences, and Prevention of Coronary Graft Failure. Circulation. 2017;136(18):1749-1764. https://doi.org/10.1161/CIRCULATIONAHA.117.027597
  3. Soylu E, Harling L, Ashrafian H, Casula R, Kokotsakis J, Athanasiou T. Adjunct coronary endarterectomy increases myocardial infarction and early mortality after coronary artery bypass grafting: a meta-analysis. Interactive Cardiovascular and Thoracic Surgery. 2014;19(3):462-473.  https://doi.org/10.1093/icvts/ivu157
  4. Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferovic PM, Sibbing D, Stefanini GG, Windecker S. ESC Scientific Document Group. 2018 ESC/EACTS Guidelines on myocardial revascularization [published correction appears in European Heart Journal. 2019;40(37):3096]. European Heart Journal. 2019;40(2):87-165.  https://doi.org/10.1093/eurheartj/ehy394
  5. Niclauss L. Techniques and standards in intraoperative graft verification by transit time flow measurement after coronary artery bypass graft surgery: a critical review. European Journal of Cardio-Thoracic Surgery. 2017;51(1):26-33.  https://doi.org/10.1093/ejcts/ezw203
  6. Akhrass R, Bakaeen FG. Intraoperative graft patency validation: Friend or foe? JTCVS Techniques. 2021;7:131-137.  https://doi.org/10.1016/j.xjtc.2020.12.040
  7. Gaudino M, Sandner S, Di Giammarco G, Di Franco A, Arai H, Asai T, Bakaeen F, Doenst T, Fremes SE, Glineur D, Kieser TM, Lawton JS, Lorusso R, Patel N, Puskas JD, Tatoulis J, Taggart DP, Vallely M, Ruel M. The Use of Intraoperative Transit Time Flow Measurement for Coronary Artery Bypass Surgery: Systematic Review of the Evidence and Expert Opinion Statements. Circulation. 2021;144(14):1160-1171. https://doi.org/10.1161/CIRCULATIONAHA.121.054311
  8. Thuijs D, Bekker M, Taggart DP, Kappetein AP, Kieser TM, Wendt D, Di Giammarco G, Trachiotis GD, Puskas JD, Head SJ. Improving coronary artery bypass grafting: a systematic review and meta-analysis on the impact of adopting transit-time flow measurement. European Journal of Cardio-Thoracic Surgery. 2019;56(4):654-663.  https://doi.org/10.1093/ejcts/ezz075
  9. Jalal A. An objective method for grading of distal disease in the grafted coronary arteries. Interactive Cardiovascular and Thoracic Surgery. 2007;6(4):451-455.  https://doi.org/10.1510/icvts.2007.156273
  10. Di Giammarco G, Canosa C, Foschi M, Rabozzi R, Marinelli D, Masuyama S, Ibrahim BM, Ranalletta RA, Penco M, Di Mauro M. Intraoperative graft verification in coronary surgery: increased diagnostic accuracy adding high-resolution epicardial ultrasonography to transit-time flow measurement. European Journal of Cardio-Thoracic Surgery. 2014;45(3):41-45.  https://doi.org/10.1093/ejcts/ezt580
  11. Kieser TM, Taggart DP. The use of intraoperative graft assessment in guiding graft revision. Annals of Cardiothoracic Surgery. 2018;7(5):652-662.  https://doi.org/10.21037/acs.2018.07.06
  12. Kieser TM, Rose S, Kowalewski R, Belenkie I. Transit-time flow predicts outcomes in coronary artery bypass graft patients: a series of 1000 consecutive arterial grafts. European Journal of Cardio-Thoracic Surgery. 2010;38(2):155-162.  https://doi.org/10.1016/j.ejcts.2010.01.026
  13. Singh SK, Desai ND, Chikazawa G, Tsuneyoshi H, Vincent J, Zagorski BM, Pen V, Moussa F, Cohen GN, Christakis GT, Fremes SE. The Graft Imaging to Improve Patency (GRIIP) clinical trial results. The Journal of Thoracic and Cardiovascular Surgery. 2010;139(2):294-301.e1.  https://doi.org/10.1016/j.jtcvs.2009.09.048
  14. Shehada SE, Mourad F, Balaj I, El Gabry M, Wendt D, Thielmann M, Schlosser T, Jakob H. Long-Term Outcomes of Coronary Endarterectomy in Patients With Complete Imaging Follow-Up [published online ahead of print, 2019 Apr 22]. Seminars in Thoracic and Cardiovascular Surgery. 2020;32(4):730-737.  https://doi.org/10.1053/j.semtcvs.2019.04.008
  15. Song Y, Xu F, Du J, Zhang J, Feng W. Coronary endarterectomy with coronary artery bypass graft decreases graft patency compared with isolated coronary artery bypass graft: a meta-analysis. Interactive Cardiovascular and Thoracic Surgery. 2017;25(1):30-36.  https://doi.org/10.1093/icvts/ivx045
  16. Nishi H, Miyamoto S, Takanashi S, Minamimura H, Ishikawa T, Kato Y, Shimizu Y. Optimal method of coronary endarterectomy for diffusely diseased coronary arteries. The Annals of Thoracic Surgery. 2005;79(3):846-853.  https://doi.org/10.1016/j.athoracsur.2004.06.070
  17. Kurbanov SK, Vlasova EE, Salichkin DV, Mayorov GB, Galayutdinov DM, Vasiliev VP, Shiryaev AA, Akchurin RS. In-hospital and one-year outcomes after coronary artery bypass grafting in patients with diffuse coronary artery disease. Kardiologicheskij vestnik. 2019;14(1):60-66. (In Russ.). https://doi.org/10.17116/Cardiobulletin20191401160
  18. Akchurin RS, Shiryaev AA, Galyautdinov DM, Vasiliev VP, Vlasova EE, Salichkin DV. Objectification of the characteristics of the distal bed of shunting vessels with diffuse atherosclerotic lesions in coronary surgery. Ateroskleroz i dislipidemii. 2019;35(2):41-49. (In Russ.).
Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.