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

Mukimov Sh.D.

National Medical Research Center of Cardiology

Scopus AuthorID: 57242748200
ORCID: 0000-0001-6191-5210

Zaikovskii V.Yu.

National Medical Research Center of Cardiology

SPIN RSCI: 2915-4367
Scopus AuthorID: 57330904500
ORCID: 0000-0002-3312-9447

Andreev A.V.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0003-0945-9400

Galyautdinov D.M.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0002-3312-9447

Vlasova E.E.

National Medical Research Center of Cardiology

RSCI AuthorID: 289380
Scopus AuthorID: 7006174730
ORCID: 0000-0003-2925-244X

Vasiliev V.P.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0002-2297-6026

Shiryaev A.A.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0002-3325-9743

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.

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

DOI: 10.17116/Cardiobulletin20211604141

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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

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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 2^nd 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

Scopus AuthorID: 57242748200
ORCID: 0000-0001-6191-5210

Zaikovskii V.Yu.

National Medical Research Center of Cardiology

SPIN RSCI: 2915-4367
Scopus AuthorID: 57330904500
ORCID: 0000-0002-3312-9447

Andreev A.V.

Regional Clinical Hospital No. 2;
Kuban State Medical University

ORCID: 0000-0003-0945-9400

Galyautdinov D.M.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0002-3312-9447

Vlasova E.E.

National Medical Research Center of Cardiology

RSCI AuthorID: 289380
Scopus AuthorID: 7006174730
ORCID: 0000-0003-2925-244X

Vasiliev V.P.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0002-2297-6026

Shiryaev A.A.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0002-3325-9743

Received:

12.10.2021

Accepted:

26.10.2021

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