Ultrasonic doppler flowmetry in intraoperative diagnosis of coronary bypass grafts incompetence

Basylev V.V., Rosseikin E.V., Mikulyak A.I., Karpunkin O.A.

Federal Centre of Cardiovascular Surgery, Penza, Russia

According to the findings of many authors, occlusion of bypass grafts may develop as early as during surgery in 4-12% of patients. At discharge from hospital this index may reach 5-20%, increasing to 30% within the first year. Incompetence of bypass grafts is in many cases a consequence of errors in surgical technique and may therefore be decreased by means of improving the control over quality of coronary bypass grafting. Using the method of ultrasound Doppler flowmetry in the conditions of artificial circulation and clamped artery, we assessed a total of 64 composite bypass grafts. Blood flow was assessed by such parameters as the pulsatility index (PI), mean volumetric blood flow velocity (Qmean), and percentage of diastolic volumetric filling (DF). The obtained results were statistically processed. The mean values of blood flow parameters were obtained, followed by determining dependence between peripheral resistance (PI) prior to removal of the clamp from the aorta and peripheral resistance (PI) measured after termination of extracorporeal circulation.

KEY WORDS: intraoperative ultrasonic Doppler flowmetry, coronary bypass graft incompetence.

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