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Influence of coronary territory on flow profiles of saphenous vein grafts

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Amin, Sanaz ; Werner, Raphael S ; Madsen, Per Lav ; Krasopoulos, George ; Taggart, David P. / Influence of coronary territory on flow profiles of saphenous vein grafts. In: Journal of Cardiothoracic Surgery. 2018 ; Vol. 13, No. 1. pp. 23.

Bibtex

@article{9f5456a3555b435c89cd89dbfb5a251f,
title = "Influence of coronary territory on flow profiles of saphenous vein grafts",
abstract = "BACKGROUND: Differing perfusion of the left and right ventricular coronary territory may influence flow-profiles of saphenous vein grafts (SVGs). We compared flow parameters, measured by transit-time flowmetry (TTFM), in left- and right-sided SVGs during coronary artery by-pass grafting (CABG).METHODS: Routine TTFM measurements were obtained in 167 SVGs to the left territory (55%) and 134 SVGs to the right territory (total of 301 SVGs in 207 patients). The four standard TTFM parameters, [mean graft flow (MGF), pulsatility index (PI), percentage diastolic filling (%DF), and percentage backward flow (%BF)] were compared. Differences in flow parameters were also examined according to surgical technique (on- vs. off-pump).RESULTS: No significant difference between coronary territories was found for MGF, PI and %BF. However, a higher %DF was noted in left-sided SVGs in the overall cohort as well as in the on-pump (both p < 0.001) and the off-pump cohorts (p = 0.07). Further, a significantly higher %BF was found in SVGs performed off-pump to the left territory (1.2 ± 2.5 vs. 2.3 ± 3.0, p = 0.023). In a multivariate regression analysis, anastomosing a SVG to the left territory was weakly associated with higher PI (OR = 0.36, p = 0.026) and strongly associated with higher %DF (OR = 5.1, p < 0.001). No significant association was found for MGF, PI, %DF or %BF in either the on-pump nor the off-pump cohorts.CONCLUSIONS: Although statistically significant, the established differences in TTFM parameters between left- and right-sided vein grafts were small and unlikely to be of clinical relevance.",
keywords = "Aged, Anastomosis, Surgical, Aorta/surgery, Blood Flow Velocity, Blood Pressure, Cardiopulmonary Bypass, Coronary Artery Bypass, Female, Heart/physiology, Humans, Male, Middle Aged, Multivariate Analysis, Retrospective Studies, Rheology, Saphenous Vein/transplantation",
author = "Sanaz Amin and Werner, {Raphael S} and Madsen, {Per Lav} and George Krasopoulos and Taggart, {David P}",
year = "2018",
month = feb,
day = "20",
doi = "10.1186/s13019-018-0709-6",
language = "English",
volume = "13",
pages = "23",
journal = "Journal of Cardiothoracic Surgery",
issn = "1749-8090",
publisher = "BioMed Central Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - Influence of coronary territory on flow profiles of saphenous vein grafts

AU - Amin, Sanaz

AU - Werner, Raphael S

AU - Madsen, Per Lav

AU - Krasopoulos, George

AU - Taggart, David P

PY - 2018/2/20

Y1 - 2018/2/20

N2 - BACKGROUND: Differing perfusion of the left and right ventricular coronary territory may influence flow-profiles of saphenous vein grafts (SVGs). We compared flow parameters, measured by transit-time flowmetry (TTFM), in left- and right-sided SVGs during coronary artery by-pass grafting (CABG).METHODS: Routine TTFM measurements were obtained in 167 SVGs to the left territory (55%) and 134 SVGs to the right territory (total of 301 SVGs in 207 patients). The four standard TTFM parameters, [mean graft flow (MGF), pulsatility index (PI), percentage diastolic filling (%DF), and percentage backward flow (%BF)] were compared. Differences in flow parameters were also examined according to surgical technique (on- vs. off-pump).RESULTS: No significant difference between coronary territories was found for MGF, PI and %BF. However, a higher %DF was noted in left-sided SVGs in the overall cohort as well as in the on-pump (both p < 0.001) and the off-pump cohorts (p = 0.07). Further, a significantly higher %BF was found in SVGs performed off-pump to the left territory (1.2 ± 2.5 vs. 2.3 ± 3.0, p = 0.023). In a multivariate regression analysis, anastomosing a SVG to the left territory was weakly associated with higher PI (OR = 0.36, p = 0.026) and strongly associated with higher %DF (OR = 5.1, p < 0.001). No significant association was found for MGF, PI, %DF or %BF in either the on-pump nor the off-pump cohorts.CONCLUSIONS: Although statistically significant, the established differences in TTFM parameters between left- and right-sided vein grafts were small and unlikely to be of clinical relevance.

AB - BACKGROUND: Differing perfusion of the left and right ventricular coronary territory may influence flow-profiles of saphenous vein grafts (SVGs). We compared flow parameters, measured by transit-time flowmetry (TTFM), in left- and right-sided SVGs during coronary artery by-pass grafting (CABG).METHODS: Routine TTFM measurements were obtained in 167 SVGs to the left territory (55%) and 134 SVGs to the right territory (total of 301 SVGs in 207 patients). The four standard TTFM parameters, [mean graft flow (MGF), pulsatility index (PI), percentage diastolic filling (%DF), and percentage backward flow (%BF)] were compared. Differences in flow parameters were also examined according to surgical technique (on- vs. off-pump).RESULTS: No significant difference between coronary territories was found for MGF, PI and %BF. However, a higher %DF was noted in left-sided SVGs in the overall cohort as well as in the on-pump (both p < 0.001) and the off-pump cohorts (p = 0.07). Further, a significantly higher %BF was found in SVGs performed off-pump to the left territory (1.2 ± 2.5 vs. 2.3 ± 3.0, p = 0.023). In a multivariate regression analysis, anastomosing a SVG to the left territory was weakly associated with higher PI (OR = 0.36, p = 0.026) and strongly associated with higher %DF (OR = 5.1, p < 0.001). No significant association was found for MGF, PI, %DF or %BF in either the on-pump nor the off-pump cohorts.CONCLUSIONS: Although statistically significant, the established differences in TTFM parameters between left- and right-sided vein grafts were small and unlikely to be of clinical relevance.

KW - Aged

KW - Anastomosis, Surgical

KW - Aorta/surgery

KW - Blood Flow Velocity

KW - Blood Pressure

KW - Cardiopulmonary Bypass

KW - Coronary Artery Bypass

KW - Female

KW - Heart/physiology

KW - Humans

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Retrospective Studies

KW - Rheology

KW - Saphenous Vein/transplantation

U2 - 10.1186/s13019-018-0709-6

DO - 10.1186/s13019-018-0709-6

M3 - Journal article

C2 - 29463268

VL - 13

SP - 23

JO - Journal of Cardiothoracic Surgery

JF - Journal of Cardiothoracic Surgery

SN - 1749-8090

IS - 1

ER -

ID: 56349386