Strengthening the quality control of coronary artery bypass grafting
10.3760/cma.j.cn112139-20200117-00037
- VernacularTitle:加强冠状动脉旁路移植术的质量控制
- Author:
Song GU
1
;
Pixiong SU
Author Information
1. 首都医科大学附属北京朝阳医院心脏外科 100020
- Keywords:
Coronary artery disease;
Coronary artery bypass;
Quality control;
Laser-Doppler flowmetry
- From:
Chinese Journal of Surgery
2020;58(5):345-349
- CountryChina
- Language:Chinese
-
Abstract:
The quality control of coronary artery bypass grafting (CABG) is an important prerequisite to the graft patency and the long-term outcomes. The evaluation of target vessel is the basis, the choice of surgical types is the means, the high-quality acquisition of graft harvesting is the guarantee, and the anastomotic method and quality is the core. As the most commonly used quality control tool, intraoperative transit time flow measurement can effectively detect the coronary graft failure caused by anastomotic stenosis and guide to repair of the graft. However, some studies showed that the positive predictive value is low, and the evidence is insufficient for the relationship with the long-term patency rate of grafts. Intraoperative instantaneous flow measurement combined with high-resolution epicardial ultrasound can improve the quality, safety and effectiveness of CABG, which should be an important recommendation for CABG quality control. Once the shape of the grafts and anastomotic ports is abnormal and the blood flow is not satisfied, it needs to adjust or re-anastomose immediately. The quality control of CABG requires comprehensive judgment and individualized measures to ensure the safety and long-term outcome of patients.
