Document Detail


Intraoperative graft flow measurements during coronary artery bypass surgery predict in-hospital outcomes.
MedLine Citation:
PMID:  18467427     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Transit-time flowmetry enables immediate intraoperative assessment of blood flow parameters in coronary artery bypass grafts (CABG). The present study assesses the predictive value of measured graft flows on early and medium-term outcomes. All cardiac surgery patients with measured graft flows were included. The last intraoperative flow measurements recorded using the Medtronic Butterfly Flowmetry system were used for analysis. Patients were separated into two groups: patients with normal flow in all grafts or patients with abnormal flow > or =1 graft. Any pulsatility index (pulsatility index=min-max flow/mean flow) < or =5 was determined to be normal flow. The study population included 985 patients. Nineteen percent of patients had abnormal flow in > or =1 graft. Overall in-hospital mortality was 4.7% and not significant between the two groups. After adjusting for covariates, the in-hospital composite outcome for adverse cardiac events was more prevalent in the abnormal flow group (31% vs. 17%; P<0.0001) with an odds ratio of 1.7 (CI 1.1-2.7). Survivors to discharge had a mean follow-up of 1.8 years. However, abnormal flow was not an independent predictor of the medium-term mortality and readmission to hospital for cardiac reason following discharge. Our findings suggest that abnormal flows measured intraoperatively are independently associated with short-term in-hospital adverse outcome.
Authors:
Christine Herman; John A Sullivan; Karen Buth; Jean-Francois Legare
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Publication Detail:
Type:  Journal Article     Date:  2008-05-08
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  7     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-30     Completed Date:  2008-10-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  582-5     Citation Subset:  IM    
Affiliation:
Department of Surgery, Division of Cardiac Surgery, Dalhousie University, Halifax, NS, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Flow Velocity
Cardiovascular Diseases / diagnosis*,  etiology,  mortality,  physiopathology
Coronary Artery Bypass / adverse effects*,  mortality
Coronary Circulation*
Female
Hospital Mortality
Humans
Intraoperative Care
Male
Middle Aged
Odds Ratio
Predictive Value of Tests
Proportional Hazards Models
Pulsatile Flow
Reoperation
Rheology / methods*
Risk Assessment
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Interact Cardiovasc Thorac Surg. 2008 Aug;7(4):585   [PMID:  18664663 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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