論文

査読有り
2007年12月

Predicting early coronary artery bypass graft failure by intraoperative transit time flow measurement

ANNALS OF THORACIC SURGERY
  • Yoshiyuki Tokuda
  • ,
  • Min-Ho Song
  • ,
  • Yuichi Ueda
  • ,
  • Akihiko Usui
  • ,
  • Toshiaki Akita

84
6
開始ページ
1928
終了ページ
1934
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.athoracsur.2007.07.040
出版者・発行元
ELSEVIER SCIENCE INC

Background. A primary limitation of using transit time flow measurement to predict early graft failure in coronary artery bypass grafting has been the lack of cutoff values for objective criteria.
Methods. We analyzed a total of 261 grafts that were evaluated by intraoperative transit time flow measurement and underwent early postoperative coronary angiography within 3 months of surgery. Based on the control angiography, failing grafts were defined as occluded or patent grafts with greater than 50% stenosis or poor flow characteristics. Normal and failing graft indicators were compared according to the graft territories.
Results. According to the receiver operating characteristic curve analysis for the grafts to left coronary arteries, a mean flow of 15 mL/min or less, a pulsatility index of 5.1 or higher, and a backward flow of 4.1% or higher were found to be the optimal cutoff criteria to predict early graft failure. Similarly, for the grafts to right coronary arteries, the cutoff values were 20 mL/min, 4.7, and 4.6%, respectively. A systolic dominant flow curve pattern was a risk factor only in grafts to the left coronary arteries. Negative predictive values of these cutoff criteria ranged from 0.91 to 0.96, whereas positive predictive values ranged from 0.31 to 0.80.
Conclusions. Using these criteria, transit time flow measurement may be a useful method to predict early graft failure. However, surgeons should be aware of the low positive predictive values to avoid unnecessary graft revision.

リンク情報
DOI
https://doi.org/10.1016/j.athoracsur.2007.07.040
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000251176300018&DestApp=WOS_CPL
ID情報
  • DOI : 10.1016/j.athoracsur.2007.07.040
  • ISSN : 0003-4975
  • Web of Science ID : WOS:000251176300018

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