A New Index of Intraoperative Transit-Time Flow Evaluation in Coronary Artery Bypass Grafting
10.4326/jjcvs.35.5
- VernacularTitle:トランジットタイム血流量計によるＣＡＢＧ術中グラフト評価の新たな指標：Ｄｉａｓｔｏｌｉｃ Ｆｉｌｌｉｎｇ Ｉｎｄｅｘ（ＤＦＩ）
- Author:
Yoshiyuki Takami
;
Hiroshi Masumoto
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2006;35(1):5-9
- CountryJapan
- Language:Japanese
-
Abstract:
It is essential to evaluate the quality of coronary artery bypass grafting (CABG) anastomosis in the operating room. Transit-time flow measurement has been increasingly used for this purpose, because it is less invasive, more reproducible, and less time consuming. The electrocardiogram-gated flow measurement has made it possible to identify the systolic flow (Qs) and diastolic flow (Qd) and to calculate a new index, diastolic filling index (DFI=100∫Qd/[∫|Qs|+∫|Qd|]) for graft flow analysis. In this study, we investigated the clinical significance of DFI, together with other indexes, including mean flow (Qm), pulsatility index (PI), % insufficiency (INSUF), and F0/H1, where F0 is a power of the fundamental frequency and H1 is a power of the first harmonic in spectral analysis by fast Fourier transformation of the flow curve. We examined the relationships of these intraoperative flow variables of the postoperative angiographic findings of 125 CABG grafts, including 58 in-situ internal thoracic arteries. There were significant differences between patent and non-patent grafts in all of the intraoperative flow parameters (Qm: 47.9±31.8ml/min vs 10.2±3.6ml/min, PI: 3.0±1.4 vs 9.6±2.4, INSUF: 3.3±4.2% vs 29.9±8.1%, F0/H1: 2.8±2.0 vs 0.6±0.2, DFI: 68.5±8.4% vs 38.2±17.2%). Our data suggested that a DFI value of more than 50% can be useful for surgeons to distinguish patent from non-patent grafts in the operating room, in combination with other parameters: Qm>15ml/min, PI<5, INSUF<15%, and F0/H1 ratio>1.0.
