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Relationship of Intraoperative Transit Time Flowmetry Findings to Angiographic Graft Patency at Follow-Up  Sanaz Amin, MBBS, Ana-Catarina Pinho-Gomes,

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Presentation on theme: "Relationship of Intraoperative Transit Time Flowmetry Findings to Angiographic Graft Patency at Follow-Up  Sanaz Amin, MBBS, Ana-Catarina Pinho-Gomes,"— Presentation transcript:

1 Relationship of Intraoperative Transit Time Flowmetry Findings to Angiographic Graft Patency at Follow-Up  Sanaz Amin, MBBS, Ana-Catarina Pinho-Gomes, MSc (Hons), MRCS, David P. Taggart, MD (Hons), PhD  The Annals of Thoracic Surgery  Volume 101, Issue 5, Pages (May 2016) DOI: /j.athoracsur Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Transit time flowmetry technique. The transducers in the transit time flowmeter are upstream and downstream of each other, and both act as a transmitter and a receiver. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Example of (A) transit time flowmeter (TTFM) and (B) ultrasound (US) imaging for a left interior mammary artery (LIMA) to left anterior descending (LAD) artery graft. (A) Main TTFM variables are provided along with a graphic representation of graft flow. The color difference distinguishes between the diastolic (blue) and the systolic (red) phases. Information on percentage of diastolic flow (DF) is also available when the electrocardiograph tracer is connected. (B) US imaging complements the functional assessment provided by TTFM by allowing a clear visualization of blood flow through the anastomosis. All measurements were done with the VeriQC device (Medi-Stim AS, Oslo, Norway) and recorded off cardiopulmonary bypass. Acoustic coupling index (ACI) measures the adequacy of probe contact, with color changing from green to yellow and red as contact deteriorates. Q1 refers to input 1, where the flow-probe was plugged in and specifies that measurement was performed with a 4-mm probe. (MGF = mean graft flow; PI = pulsatility index.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Example of a successful application of transit time flowmetry (TTFM) to aid decision making regarding graft revision. (A) and (B) TTFM of a right internal mammary artery (RIMA) to the intermediate (IM) artery performed off cardiopulmonary bypass (CPB) before (A) and after (B) revision. (C) and (D) TTFM of a left internal mammary artery (LIMA) to the left anterior descending (LAD) artery performed on CPB before (C) and after (D) revision. Graft revision resulted in a significant increase in mean graft flow (MGF) associated with a decrease in pulsatility index (PI). The surgeon was not aware of any technical errors before flow measurement, and the graft would not have been revised if TTFM were unavailable. The final measurements are in keeping with the standards recommended for an adequate graft. All measurements were done with the VeriQC device (Medi-Stim AS, Oslo, Norway) and recorded on or off CPB. Acoustic coupling index (ACI) measures the adequacy of probe contact, with color changing from green to yellow and red as contact deteriorates. Q1 refers to input 1, where the flow-probe was plugged in and specifies that measurement was performed with a (A and B) 3-mm probe or a (C and D) 2-mm probe. (DF% = percentage of diastolic flow.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

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