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...In seconds, Transonic Flow-QC
provides an on-the-spot, functional assessment of true volume flow in ml/min or L/min. Contact us for a Demonstration >
Flow Guided CABG Surgery: On or Off Pump
Routine intraoperative measurements with Transonic Flow-QC identify compromised graft flow, even in the presence of a palpable pulse, and
allow prompt revision of technical problems before the patient leaves the operating room. If it's worth taking the time to construct a bypass graft, it's worth knowing
whether or not it's patent.
"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
"...we use the flowprobe as part of our routine monitoring of the post-bypass patient. It gives us, intraoperatively,
information about what's transpiring with each individual graft. It's information that you could not get any other way."
E. Grossi, MD, New York University
More Surgeon Testimonials >
Immediately after revascularization of the LIMA-LAD anastomosis, blood flow through the LIMA is measured and compared with
the reading obtained before division of LIMA using an ultrasonic transit-time flowmeter (Transonic Systems Inc., Ithaca, NY); we
accept mean flow after LIMA-LAD greater than 15 mL/min and require documentation of "diastolization" of flow pattern through the LIMA-LAD."
M. Zenati et al, Ann Thorac Surg 63: S84-87, 1997.
Coronary Graft Patency Assesment Protocol
MIDCAB Note, M10 - Protocol for measuring coronary artery bypass graft flows during minimally invasive coronary
artery bypass surgery.
HeartNet.org - World Wide Web Registry for tracking patient outcomes following MIDCAB
Continuous Cardiac Output Measurements
Transonic Flow-QC augments your intraoperative monitoring of the cardiac surgery patient with beat-to-beat cardiac output and assessment of reguritant flow during
valve, congenital and multi-vessel, beating heart CABG.
"We have found the flow measurements to be of great value during
dislocation of the beating heart...continuous cardiac output measurements assist our anesthesiologist in the management of the patient."
E. Jansen, MD, Univ. of Utrecht Hospital, The Netherlands
Case Examples
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Simultaneous arterial and venous coronary
graft flows. Top: left internal thoracic artery graft to left anterior descending artery. Bottom: saphenous vein graft to obtuse marginal artery. Waveforms courtesy of C.
Canver, MD, Albany Medical College
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Kinked Saphenous Vein Graft
A 74-year-old male patient with critical ischemia underwent triple bypass surgery to restore blood
supply to the heart. A Transonic 2.5 mm probe (H2MB) and a 3 mm probe (H3MB) were used to measure flows in the anastomosed grafts immediately
prior to sternal closure. Two of the grafts, the internal mammary artery (IMA) to the left anterior descending artery (LAD), and a
saphenous vein graft (SVG) to the posterior descending artery had adequate graft flows of 28 ml/min and 45 ml/min respectively. When flow in the SVG to the
left main circumflex artery was measured, it was zero. Pulse and pressure were present in all three grafts. Flow measurements were repeated and results were
reproducible. Upon close inspection of the SVG to the circumflex, a kink was found. The graft was repositioned and flows were again measured. Graft blood flow
reading in the repositioned graft was 62 ml/min.
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Internal thoracic artery graft flow before
and after MIDCAB. Waveforms courtesy of M. Zenati, MD, Univ. of Pittsburgh Med Ctr.
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Internal Mammary Flows during CABG
An 81-year old female patient, considered too ill for conventional CABG surgery, underwent beating
heart CABG via a left anterior small thoracotomy to bypass a critically stenosed LAD. While the heart was slowed and mechanically immobilized, the anastomosis was
performed on the beating heart. The mammary pedicle was prepared for flow measurments by partially dissecting a small (1-1.5 cm) segment of the artery near
the distal end. A 3 mm flowprobe was inserted into sterile gel and applied to the skeletonized portion of the IMA. Following completion of the anastomosis, the
mean graft flow was 34 ml/min. The waveform printout of the left IMA to LAD graft documented the expected predominately diastolic flow pattern.
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Simultaneous cardiac output and graft
flow measurements during beating heart, multivessel CABG. Waveforms courtesy of E. Jansen MD, Univ. of Utrecht Hospital
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A male 64-year-old male patient
underwent double coronary artery bypass grafting. CP bypass was not used, but a full sternotomy was performed to allow greater access to the beating heart. A 32
mm cardiac output flowprobe was placed on the ascending aorta just above the aortic root. As the heart was slowed with esmolol, cardiac output was monitored
allowing the anesthesiologist to adjust the amount of drug infusion.
Transonic A-Series flowprobe
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