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  • 58 -3 (89) 2026 - Sh.U. Buranov - INTRAOPERATIVE TRANSIT TIME FLOWMETRY DURING OFF-PUMP CORONARY ARTERY BYPASS GRAFTING: EARLY OUTCOME OF TWO DIFFERENT ANASTOMOSIS TECHNIQUE

58 -3 (89) 2026 - Sh.U. Buranov - INTRAOPERATIVE TRANSIT TIME FLOWMETRY DURING OFF-PUMP CORONARY ARTERY BYPASS GRAFTING: EARLY OUTCOME OF TWO DIFFERENT ANASTOMOSIS TECHNIQUE

INTRAOPERATIVE TRANSIT TIME FLOWMETRY DURING OFF-PUMP CORONARY ARTERY BYPASS GRAFTING: EARLY OUTCOME OF TWO DIFFERENT ANASTOMOSIS TECHNIQUE

Sh.U. Buranov - Bukhara branch of the Republican Scientific Center for Emergency Medical Care Uzbekistan

Resume

Intraoperative transit time flowmetry (TTF) is an essential technique for evaluating graft function during off-pump coronary artery bypass grafting (OPCABG). This study compares graft quality and outcomes using TTF in two surgical approaches: sequential and Y-type saphenous vein grafting. A total of 120 patients with triple-vessel coronary artery disease were enrolled and randomized into two groups: Group 1 (n = 60) received sequential grafts; Group 2 (n = 60) received Y-grafts. Mean graft flow (MGF) and pulsatility index (PI) were measured intraoperatively. Graft function was classified based on flow > 15 ml/min and PI < 2.5. All patients underwent coronary CT angiography at 48 months to assess graft patency. Intraoperative TTF showed no significant difference in MGF or PI between graft types, although sequential grafts demonstrated slightly higher flow and lower resistance. Intraoperative graft failure occurred in 1.7% (sequential) vs. 3.3% (Y-grafts). At 48-month follow-up, sequential grafts showed 100% patency, while Y-grafts had a 7.0% occlusion rate. Multivariate analysis identified vessel diameter and conduit type as significant predictors of graft performance; graft configuration (sequential vs. Y) was not independently predictive. TTF is a valuable intraoperative tool for ensuring graft functionality in OPCABG. While both techniques are viable, sequential grafting demonstrated superior mid-term patency and lower failure rates. These findings support the preferential use of sequential grafting when anatomically feasible and highlight the importance of routine TTF to optimize surgical outcomes.

Keywords: Coronary artery bypass grafting, Off-pump coronary artery bypass grafting, Transit time flowmetry

First page

358

Last page

366

For citation:Sh.U. Buranov - INTRAOPERATIVE TRANSIT TIME FLOWMETRY DURING OFF-PUMP CORONARY ARTERY BYPASS GRAFTING: EARLY OUTCOME OF TWO DIFFERENT ANASTOMOSIS TECHNIQUE//New Day in Medicine 3(89)2026 358-366 https://newdayworldmedicine.com/en/new_day_medicine/3-89-2026

List of References

  1. Fitzgibbon GM, Kafka HP, Leach AJ, Keon WJ, Hooper GD, Burton JR. Coronary bypass graft fate and patient outcome: angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 years. J Am Coll Cardiol. 1996;28(3):616-626. doi:10.1016/0735-1097(96)00206-9.
  2. Bakaeen FG, Blackstone EH, Pettersson GB, Gillinov AM, Svensson LG, Lytle BW. Contemporary coronary artery bypass grafting using bilateral internal thoracic arteries: is it safe? J Thorac Cardiovasc Surg. 2009;137(3):539-546. doi:10.1016/j.jtcvs.2008.06.026.
  3. Sabik JF, Stockins A, Nowicki ER, Blackstone EH, Houghtaling PL, Lytle BW. Comparison of patency of internal thoracic artery–coronary artery anastomoses with other conduits. Ann Thorac Surg. 2005;79(2):544-551. doi:10.1016/j.athoracsur.2004.07.008.
  4. Kim KB, Lim C, Ahn H, Yang JK, Yoo KJ, Lee SK. Off-pump coronary artery bypass: 10-year experience and outcomes. Ann Thorac Surg. 2004;78(1):149-153. doi:10.1016/j.athoracsur.2004.02.055.
  5. D’Ancona G, Karamanoukian HL, Ricci M, Salerno TA, Bergsland J. Graft patency verification in coronary artery bypass surgery by transit-time flow measurement. Ann Thorac Surg. 2000;70(3):434-439. doi:10.1016/S0003-4975(00)01401-3.
  6. Kieser TM, Rose MS, Kowalewski R, Belenkie I. Transit-time flow measurement in coronary artery bypass surgery: a systematic review and meta-analysis. J Card Surg. 2012;27(3):302-309. doi:10.1111/j.1540-8191.2012.01407.x.
  7. Smith J, Allen R, Kapoor N, Mehta V, Singh D, Brown R. Impact of intraoperative ultrasound flowmetry on graft patency in off-pump coronary artery bypass grafting. J Cardiothorac Surg. 2020;15(1):45. doi:10.1186/s13019-020-01104-w.
  8. Joshi MM, Paul S, Bhosle KN, Nagre SW, Parashi H, Jadhao M, et al. Individual versus sequential saphenous vein grafts for on-pump coronary artery bypass grafting – does smaller coronaries in Indians affect graft choice? A mid-term patency comparison study. J Saudi Heart Assoc. 2021;33(2):109-116. doi:10.37616/2212-5043.1245.
  9. Li J, Gu C. Comparison of blood flow in single and sequential vein grafts during off-pump coronary artery bypass. J Thorac Dis. 2019;11(8):3341-3346. doi:10.21037/jtd.2019.08.41.
  10. Lee JH, Chun EJ, Choi SI, Vembar M, Lim C, Park KH, et al. Prospective versus retrospective ECG-gated 64-detector coronary CT angiography for evaluation of coronary artery bypass graft patency: comparison of image quality, radiation dose and diagnostic accuracy. Int J Cardiovasc Imaging. 2011;27(5):657-667. doi:10.1007/s10554-011-9904-4.
  11. Di Lazzaro D, Crusco F. CT angio for the evaluation of graft patency. J Thorac Dis. 2017;9(Suppl 4):S283-S288. doi:10.21037/jtd.2017.03.111.
  12. Lee JH, Chun EJ, Choi SI, Vembar M, Lim C, Park KH, et al. Prospective versus retrospective ECG-gated 64-detector coronary CT angiography for evaluation of coronary artery bypass graft patency: comparison of image quality, radiation dose and diagnostic accuracy. Int J Cardiovasc Imaging. 2011;27(5):657-667. doi:10.1007/s10554-011-9904-4.
  13. Di Lazzaro D, Crusco F. CT angio for the evaluation of graft patency. J Thorac Dis. 2017;9(Suppl 4):S283-S288. doi:10.21037/jtd.2017.03.111.

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