Correlation between Preoperative Coronary Artery Stenosis Severity Measured by Instantaneous Wave-Free Ratio and Intraoperative Transit Time Flow Measurement of Attached Grafts
| Autor: | Rimantas Benetis, Ramunas Unikas, Arslan Mamedov, Almas Tolegenuly, Rasa Ordiene |
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| Rok vydání: | 2020 |
| Předmět: |
Medicine (General)
medicine.medical_specialty coronary artery bypass grafting Coronary stenosis Coronary Angiography Article Flow measurement Coronary artery disease Coronary circulation R5-920 Internal medicine Humans Medicine Instantaneous wave-free ratio Vascular Patency business.industry Coronary Stenosis Coronary artery bypass grafting Transit time flow measurement Competitive flow Early graft failure General Medicine competitive flow instantaneous wave-free ratio medicine.disease transit time flow measurement early graft failure Coronary arteries Stenosis Treatment Outcome surgical procedures operative medicine.anatomical_structure Cardiology business Blood Flow Velocity Artery |
| Zdroj: | Medicina Volume 56 Issue 12 Medicina, Kaunas ; Basel : LSMU ; MDPI, 2020, vol. 56, no. 12, 714, p. 1-11 Medicina, Vol 56, Iss 714, p 714 (2020) Medicina; Volume 56; Issue 12; Pages: 714 |
| ISSN: | 1648-9144 1010-660X |
| DOI: | 10.3390/medicina56120714 |
| Popis: | Background and Objectives: To assess the correlation between the degree of target coronary artery stenosis measured by instantaneous wave-free ratio (iFR) and the intraoperative transit time flow measurement (TTFM) of attached grafts as well as evaluate flow competition between the native coronary artery and the attached graft according to the severity of stenosis. Materials and Methods: In total, 89 grafts were subjected to intraoperative transit time flow measurement after coronary artery bypass grafting (CABG) in 25 patients with multivessel coronary artery disease (CAD). The iFR was evaluated for all coronary arteries with grafts. The coronary artery stenoses were divided into three groups based on the iFR value: iFR < 0.86 (group 1) iFR 0.86&ndash 0.90 (group 2) and iFR > 0.90 (group 3). Results: The mean graft flow (MGF) was 46.9 ± 18.4 mL/min for group 1, 45.3 ± 20.9 mL/min for group 2, and 31.3 ± 18.5 mL/min for group 3. A statistically significant difference was confirmed between groups 1 and 3 (p = 0.002) and between groups 2 and 3 (p = 0.025). The pulsatility index (PI) was 2.49 ± 1.20 for group 1, 2.66 ± 2.13 for group 2, and 4.70 ± 3.66 for group 3. A statistically significant difference was found between groups 1 and 3 (p = 0.006) and between groups 2 and 3 (p = 0.032). Backward flow was detected in 7.5% of grafts for group 1, in 16.6% of grafts for group 2, and in 16% of grafts for group 3. A statistically significant difference was found between groups 1 and 2 (p = 0.025) and between groups 1 and 3 (p = 0.029). Conclusions: The iFR is a useful tool for predicting the impact of competitive flow observed between a native artery and an attached graft. The effect of competitive flow significantly increases when the graft is attached to a vessel with mild coronary stenosis. In a coronary artery where the iFR was not hemodynamically significant, the MGF was lower, the PI was higher, and a larger proportion of grafts with backward flow (BF) was detected compared to when there was significant stenosis (iFR < 0.86). |
| Databáze: | OpenAIRE |
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