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Maximal blood flow acceleration analysis in the early diastolic phase for aortocoronary artery bypass grafts: a new transit-time flow measurement predictor of graft failure following coronary artery bypass grafting

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Abstract

Purpose

Maximal graft flow acceleration (max df/dt) determined using transit-time flowmetry (TTFM) in the diastolic phase was assessed as a potential predictor of graft failure for aortocoronary artery (AC) bypass grafts in coronary artery bypass patients.

Methods

Max df/dt was retrospectively measured in 114 aortocoronary artery bypass grafts. TTFM data were fitted to a 9-polynomial curve, which was derived from the first-derivative curve, to measure max df/dt (9-polynomial max df/dt). Abnormal TTFM was defined as a mean flow of <15 ml/min, a pulsatility index of >5 or a diastolic filling ratio of <50 %. Postoperative assessments were routinely performed by coronary artery angiography (CAG) at 1 year after surgery.

Results

Using TTFM, 68 grafts were normal, 4 of which were failing on CAG, and 46 grafts were abnormal, 21 of which were failing on CAG. 9-polynomial max df/dt was significantly lower in abnormal TTFM/failing by the CAG group compared with abnormal TTFM/patent by the CAG group (1.08 ± 0.89 vs. 2.05 ± 1.51 ml/s2, respectively; P < 0.01, Mann–Whitney U test, Holm adjustment).

Conclusions

TTFM 9-polynomial max df/dt in the early diastolic phase may be a promising predictor of future graft failure for AC bypass grafts, particularly in abnormal TTFM grafts.

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Authors and Affiliations

  1. Department of Surgery 2, Kochi University, Nankoku, Kochi, 783-8505, Japan

    Takemi Handa, Kazumasa Orihashi, Hideaki Nishimori & Masaki Yamamoto

Authors
  1. Takemi Handa
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  2. Kazumasa Orihashi
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  3. Hideaki Nishimori
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  4. Masaki Yamamoto
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Correspondence to Takemi Handa.

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None of the authors have any conflicts of interest related to this study.

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Handa, T., Orihashi, K., Nishimori, H. et al. Maximal blood flow acceleration analysis in the early diastolic phase for aortocoronary artery bypass grafts: a new transit-time flow measurement predictor of graft failure following coronary artery bypass grafting. Surg Today 46, 1325–1333 (2016). https://doi.org/10.1007/s00595-016-1325-5

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  • DOI: https://doi.org/10.1007/s00595-016-1325-5

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