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David P Taggart - One of the best experts on this subject based on the ideXlab platform.
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Relationship of Intraoperative Transit Time Flowmetry Findings to Angiographic Graft Patency at Follow-Up.
The Annals of thoracic surgery, 2016Co-Authors: Sanaz Amin, Ana-catarina Pinho-gomes, David P TaggartAbstract:Early and late Graft occlusion remains a significant complication of coronary artery bypass Grafting. Transit time flowmetry is the most commonly used imaging technique to assess Graft Patency intraoperatively. Although the value of transit time flowmetry for intraoperative quality control of coronary anastomosis is well established, its standard variables for predicting eventual Graft failure remain controversial. This review readdresses the issue of intraoperative transit time flowmetry, with a particular emphasis on defining cutoff values for standard variables and correlating them with the ability to predict midterm and long-term Graft Patency for arterial and venous conduits. Further research is warranted to support clinically useful recommendations on the intraoperative application and interpretation of transit time flowmetry.
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intraoperative imaging techniques to assess coronary artery bypass Graft Patency
The Annals of Thoracic Surgery, 2007Co-Authors: Lognathen Balacumaraswami, David P TaggartAbstract:Graft Patency verification is increasingly recognized as an important component of coronary artery bypass Grafting. Intuitively, eliminating intraoperative Graft failure should reduce cardiac mortality and morbidity in the short term and improve clinical outcome in the long term. Although conventional angiography remains the gold standard technique for assessing Graft Patency, it is rarely available in the operating room and consequently several other less invasive approaches have been advocated. This article reviews the two currently most commonly used modalities for Graft Patency assessment, intraoperative fluorescence imaging and transit-time flowmetry, and discusses their value and limitations. Both techniques can reliably detect otherwise unsuspected occluded Grafts and this is crucial for internal thoracic arteries because of their prognostic significance. Although neither technology can consistently identify more minor, non-occlusive abnormalities, the intraoperative fluorescence imaging technique seems to be more sensitive and less susceptible to "false positive" images.
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a comparison of transit time flowmetry and intraoperative fluorescence imaging for assessing coronary artery bypass Graft Patency
The Journal of Thoracic and Cardiovascular Surgery, 2005Co-Authors: Lognathen Balacumaraswami, Yasir Abuomar, Bikram P Choudhary, David Pigott, David P TaggartAbstract:Background Intraoperative Graft Patency assessment during coronary artery bypass Grafting enables detection and immediate correction of Graft failure. Currently transit-time flowmetry is used to assess Graft Patency on the basis of mean Graft flow and derived values, such as the pulsatility index. Intraoperative fluorescence imaging, based on the fluorescence of indocyanine green dye, provides direct visual images to confirm Graft Patency. Methods We performed a prospective observational study to assess intraoperative Graft Patency in patients undergoing coronary artery bypass Grafting, by using an intraoperative fluorescence imaging system (SPY) and transit-time flowmetry (BF 2004). Poor flow with the intraoperative fluorescence imaging system was defined if there was an absence of fluorescence or if it did not appear within 15 seconds in the Graft. A persistent mean Graft flow value less than 5 mL/min and a pulsatility index greater than 5 with transit-time flowmetry were considered unacceptable and prompted Graft revision. Results We assessed the intraoperative Patency of 266 Grafts in 100 coronary artery bypass Grafting patients. Intraoperative fluorescence imaging and transit-time flowmetry confirmed adequate flow in 241 (91%) Grafts in 75 patients (75%). Transient poor flow was detected with both intraoperative fluorescence imaging and transit-time flowmetry in 7 (2.6%) Grafts in 7 (7%) patients. This subsequently proved to be adequate on repeat testing and hence did not necessitate Graft revision. Both intraoperative fluorescence imaging and transit-time flowmetry confirmed persistent poor flow in 8 (3%) Grafts in 8 (8%) patients that necessitated Graft revision. However, in a further 10 (3.8%) Grafts in 10 (10%) patients, transit-time flowmetry indicated persistently poor flows on the basis of mean Graft flow and pulsatility index values, whereas the intraoperative fluorescence imaging system demonstrated satisfactory flow. These Grafts were not revised. Conclusions In most patients, both intraoperative fluorescence imaging and transit-time flowmetry are useful to confirm intraoperative Graft Patency. However, in a small proportion of patients (10%), Graft Patency assessment with transit-time flowmetry alone might prompt unnecessary Graft revision.
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digital tools to facilitate intraoperative coronary artery bypass Graft Patency assessment
Seminars in Thoracic and Cardiovascular Surgery, 2004Co-Authors: Lognathen Balacumaraswami, David P TaggartAbstract:Intraoperative Graft failure is an important cause of cardiac mortality and morbidity. Hence, verification of Graft Patency should be one of the most important aspects of coronary artery bypass Grafting. Although several techniques have been advocated to assess intraoperative Graft Patency, there is no unanimously accepted method. Intraoperative fluorescence imaging is a novel technique based on the fluorescence of indocyanine green dye, which provides real-time visual images of Graft flow in the operating room. Transit-time flowmetry is based on the ultrasound principle and provides mean Graft flow and derived values such as pulsatility index. This article describes the usefulness and limitations of various techniques in general and summarizes the current knowledge with the use of these two techniques in the setting of intraoperative coronary artery bypass Graft Patency assessment.
Mehmet Karahan - One of the best experts on this subject based on the ideXlab platform.
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preoperative neutrophil lymphocyte ratio and saphenous vein Graft Patency after coronary artery bypass Grafting
Clinical and Applied Thrombosis-Hemostasis, 2014Co-Authors: İrfan Taşoğlu, Osman Turak, Yunus Nazli, Firat Ozcan, Necmettin Colak, Serpil Sahin, Kemal Kavasoglu, Bahadir Genc, Dogan Emre Sert, Mehmet KarahanAbstract:AIM: The aim of the present study was to investigate the predictive value of preoperative neutrophil-lymphocyte ratio (NLR) in postoperative saphenous vein Graft Patency in patients undergoing coronary artery bypass Grafting (CABG) surgery. METHOD: We retrospectively analyzed 444 patients who had undergone CABG and a further control coronary angiography due to recurrence of symptoms. The patients were divided into tertile groups according to the NLR. The primary end point was 50% saphenous vein Graft stenosis or more or complete occlusion. RESULT: The saphenous vein Graft failure in the 3 groups based on NLR was 33%, 66.2%, and 79.1%, in the low-, middle- and high-risk groups, respectively. In multivariate regression modeling, current smoker, diabetes mellitus, target artery diameter <1.5 mm, and NLR independently predicted saphenous vein Graft Patency in patients after CABG. CONCLUSION: Preoperative NLR is clearly an independent predictor of saphenous vein Graft Patency in patients after CABG.
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preoperative neutrophil lymphocyte ratio and saphenous vein Graft Patency after coronary artery bypass Grafting
Clinical and Applied Thrombosis-Hemostasis, 2014Co-Authors: İrfan Taşoğlu, Osman Turak, Yunus Nazli, Firat Ozcan, Necmettin Colak, Serpil Sahin, Kemal Kavasoglu, Bahadir Genc, Dogan Emre Sert, Mehmet KarahanAbstract:Aim:The aim of the present study was to investigate the predictive value of preoperative neutrophil–lymphocyte ratio (NLR) in postoperative saphenous vein Graft Patency in patients undergoing coron...
Lognathen Balacumaraswami - One of the best experts on this subject based on the ideXlab platform.
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intraoperative imaging techniques to assess coronary artery bypass Graft Patency
The Annals of Thoracic Surgery, 2007Co-Authors: Lognathen Balacumaraswami, David P TaggartAbstract:Graft Patency verification is increasingly recognized as an important component of coronary artery bypass Grafting. Intuitively, eliminating intraoperative Graft failure should reduce cardiac mortality and morbidity in the short term and improve clinical outcome in the long term. Although conventional angiography remains the gold standard technique for assessing Graft Patency, it is rarely available in the operating room and consequently several other less invasive approaches have been advocated. This article reviews the two currently most commonly used modalities for Graft Patency assessment, intraoperative fluorescence imaging and transit-time flowmetry, and discusses their value and limitations. Both techniques can reliably detect otherwise unsuspected occluded Grafts and this is crucial for internal thoracic arteries because of their prognostic significance. Although neither technology can consistently identify more minor, non-occlusive abnormalities, the intraoperative fluorescence imaging technique seems to be more sensitive and less susceptible to "false positive" images.
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a comparison of transit time flowmetry and intraoperative fluorescence imaging for assessing coronary artery bypass Graft Patency
The Journal of Thoracic and Cardiovascular Surgery, 2005Co-Authors: Lognathen Balacumaraswami, Yasir Abuomar, Bikram P Choudhary, David Pigott, David P TaggartAbstract:Background Intraoperative Graft Patency assessment during coronary artery bypass Grafting enables detection and immediate correction of Graft failure. Currently transit-time flowmetry is used to assess Graft Patency on the basis of mean Graft flow and derived values, such as the pulsatility index. Intraoperative fluorescence imaging, based on the fluorescence of indocyanine green dye, provides direct visual images to confirm Graft Patency. Methods We performed a prospective observational study to assess intraoperative Graft Patency in patients undergoing coronary artery bypass Grafting, by using an intraoperative fluorescence imaging system (SPY) and transit-time flowmetry (BF 2004). Poor flow with the intraoperative fluorescence imaging system was defined if there was an absence of fluorescence or if it did not appear within 15 seconds in the Graft. A persistent mean Graft flow value less than 5 mL/min and a pulsatility index greater than 5 with transit-time flowmetry were considered unacceptable and prompted Graft revision. Results We assessed the intraoperative Patency of 266 Grafts in 100 coronary artery bypass Grafting patients. Intraoperative fluorescence imaging and transit-time flowmetry confirmed adequate flow in 241 (91%) Grafts in 75 patients (75%). Transient poor flow was detected with both intraoperative fluorescence imaging and transit-time flowmetry in 7 (2.6%) Grafts in 7 (7%) patients. This subsequently proved to be adequate on repeat testing and hence did not necessitate Graft revision. Both intraoperative fluorescence imaging and transit-time flowmetry confirmed persistent poor flow in 8 (3%) Grafts in 8 (8%) patients that necessitated Graft revision. However, in a further 10 (3.8%) Grafts in 10 (10%) patients, transit-time flowmetry indicated persistently poor flows on the basis of mean Graft flow and pulsatility index values, whereas the intraoperative fluorescence imaging system demonstrated satisfactory flow. These Grafts were not revised. Conclusions In most patients, both intraoperative fluorescence imaging and transit-time flowmetry are useful to confirm intraoperative Graft Patency. However, in a small proportion of patients (10%), Graft Patency assessment with transit-time flowmetry alone might prompt unnecessary Graft revision.
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digital tools to facilitate intraoperative coronary artery bypass Graft Patency assessment
Seminars in Thoracic and Cardiovascular Surgery, 2004Co-Authors: Lognathen Balacumaraswami, David P TaggartAbstract:Intraoperative Graft failure is an important cause of cardiac mortality and morbidity. Hence, verification of Graft Patency should be one of the most important aspects of coronary artery bypass Grafting. Although several techniques have been advocated to assess intraoperative Graft Patency, there is no unanimously accepted method. Intraoperative fluorescence imaging is a novel technique based on the fluorescence of indocyanine green dye, which provides real-time visual images of Graft flow in the operating room. Transit-time flowmetry is based on the ultrasound principle and provides mean Graft flow and derived values such as pulsatility index. This article describes the usefulness and limitations of various techniques in general and summarizes the current knowledge with the use of these two techniques in the setting of intraoperative coronary artery bypass Graft Patency assessment.
İrfan Taşoğlu - One of the best experts on this subject based on the ideXlab platform.
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Does really previous stenting affect Graft Patency following CABG? A 5-year follow-up
Heart and vessels, 2015Co-Authors: Murat Songur, Sertan Özyalçın, Anil Ozen, Erdal Şimşek, Umit Kervan, İrfan Taşoğlu, Sadi Kaplan, Kenan Köse, Ahmet Tulga UlusAbstract:The aim of this study was to compare the Graft Patency rates among patients who had a previous history of percutaneous coronary intervention (PCI) followed by coronary artery bypass Grafting surgery (CABG) with the patients who had experienced CABG surgery alone. The 69 patients who were included in the study had a history of bare metal stent implantation prior to CABG (group 1). The coronary angiography results were compared with 69 patients who had a previous history of CABG (group 2). Graft Patency rates of the left anterior descending artery and circumflex anastomoses are statistically significant for both groups, whereas the right coronary artery anastomoses are not statistically significant (p = 0.008; 0.009; 0.2). Graft Patency rate of LIMA–LAD anastomoses was 43.9 ± 10.8 % in group 1 and 86.2 ± 6 % in group 2 for means of 60 months (p = 0.0001) and circumflex coronary artery anastomosis is 28.9 ± 0.9 % in group 1, 65.7 ± 10.8 % in group 2 (p = 0.0001) and the right coronary artery anastomosis is 37.2 ± 13.6 % in group 1, 56.4 ± 8.9 % in group 2 (p = 0.0001). The Graft Patency rates of coronary arteries without previous stent implantation were higher than the patients with previous stent implantation and experienced CABG. The results suggest that prior PCI may induce atherosclerotic events in the vessel that can adversely affect Graft Patency after surgery.
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preoperative neutrophil lymphocyte ratio and saphenous vein Graft Patency after coronary artery bypass Grafting
Clinical and Applied Thrombosis-Hemostasis, 2014Co-Authors: İrfan Taşoğlu, Osman Turak, Yunus Nazli, Firat Ozcan, Necmettin Colak, Serpil Sahin, Kemal Kavasoglu, Bahadir Genc, Dogan Emre Sert, Mehmet KarahanAbstract:AIM: The aim of the present study was to investigate the predictive value of preoperative neutrophil-lymphocyte ratio (NLR) in postoperative saphenous vein Graft Patency in patients undergoing coronary artery bypass Grafting (CABG) surgery. METHOD: We retrospectively analyzed 444 patients who had undergone CABG and a further control coronary angiography due to recurrence of symptoms. The patients were divided into tertile groups according to the NLR. The primary end point was 50% saphenous vein Graft stenosis or more or complete occlusion. RESULT: The saphenous vein Graft failure in the 3 groups based on NLR was 33%, 66.2%, and 79.1%, in the low-, middle- and high-risk groups, respectively. In multivariate regression modeling, current smoker, diabetes mellitus, target artery diameter <1.5 mm, and NLR independently predicted saphenous vein Graft Patency in patients after CABG. CONCLUSION: Preoperative NLR is clearly an independent predictor of saphenous vein Graft Patency in patients after CABG.
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preoperative neutrophil lymphocyte ratio and saphenous vein Graft Patency after coronary artery bypass Grafting
Clinical and Applied Thrombosis-Hemostasis, 2014Co-Authors: İrfan Taşoğlu, Osman Turak, Yunus Nazli, Firat Ozcan, Necmettin Colak, Serpil Sahin, Kemal Kavasoglu, Bahadir Genc, Dogan Emre Sert, Mehmet KarahanAbstract:Aim:The aim of the present study was to investigate the predictive value of preoperative neutrophil–lymphocyte ratio (NLR) in postoperative saphenous vein Graft Patency in patients undergoing coron...
Shuji Yamamoto - One of the best experts on this subject based on the ideXlab platform.
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Relation of waveform of transit-time flow measurement and Graft Patency in coronary artery bypass Grafting
The Journal of thoracic and cardiovascular surgery, 2007Co-Authors: Atsutoshi Hatada, Tatsuya Yoshimasu, Masahiro Kaneko, Mitsumasa Kawago, Mitsuru Yuzaki, Kentaro Honda, Shigeru Komori, Masahiro Iwahashi, Hiroki Hayashi, Shuji YamamotoAbstract:Graft Patency is the major factor limiting the initial clinical benefits of revascularization and patient survival; however, it is not easy to anticipate. Transit-time flow measurement (TTFM) has been the common method of assessing intraoperative coronary artery bypass Grafting (CABG) Patency because it is a noninvasive and easy method. TTFM provides a mean Graft flow (MGF), a flow waveform, and derived values such as the pulsatility index (PI). D’Ancona and colleagues 1 reported the necessity to revise 3% of Grafts on the basis of TTFM and emphasized the crucial feature of flow value interpretation as an index of Graft Patency. Takami and Ina 2 reported the relation between the Graft flow waveform and the anastomotic quality of CABG using a fast Fourier transformation (FFT) analysis. However, there have been no reports that Graft Patency can be anticipated using analysis of the Graft flow waveform. We demonstrate that Graft Patency can be assessed with FFT analysis of TTFM waveform.
