CABG Patency Assessment

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Coronary Artery Bypass Graft Patency Assessment

"The intraoperative use of flow measurements provide invaluable information in a timely, accurate, cost-effective manner allowing for the surgical correction of a surgical problem. This has significantly reduced the complications related to early technically induced graft failure. In an era of rapidly changing surgical techniques this provides documentation of the sine-quo-non of the operation: patency."

- Bruce Mindich, MD, The Valley Hospital, Ridgewood, NJ

Reduction of Technical Problems Utilizing Flow Measurements
(ppt by Dr. B. Mindich).

Flow-QC® Measurement Rules of Thumb^*:

Assess Mean Flow to Confirm Graft Patency

Normal 30 ml/min (or higher) Mean Flow = Patent Graft
Flow under 5 ml/min = Graft in Trouble
See factors that affect flow >

Perform Waveform Analysis to Grafts with Medium Range Flows between 5 - 30+ ml/min

Does flow exhibit the expected pattern?
For left ventricle grafts: a diastolic dominant waveform.
For right-ventricle grafts: a systolic/diastolic balanced waveform

Evaluate Diastolic / Systolic Ratio (D/S) and Pulsatility Index

D/S ratio should reflect a diastolic dominant flow component for left heart grafts, and D/S balanced ratios for right heart grafts.
The Pulsatility Index (PI) should be between 1 and 5.

*Rule of thumb values are based on compilation of western patient data. Each patient graft flow values should be evaluated based on individual physiological parameters.

Tips for Successful Measurements: