Improving coronary artery bypass grafting: a systematic review and meta-analysis on the impact of adopting transit-time flow measurement
Key result
Intraoperative transit-time flow measurement during CABG prompts graft revision in ~4% of patients.
- 95% CI 3.3-5.7
- n=8,943
Why the study?
Despite numerous studies on intraoperative graft flow assessment with TTFM on outcomes after CABG, adoption of contemporary TTFM remains low.
Does intraoperative transit-time flow measurement (TTFM) improve graft assessment and revision rates in patients undergoing CABG?
Population
8943 patients (15 673 grafts) across 35 studies reporting on abnormal grafts or graft revisions
Comparison
Intraoperative TTFM graft flow assessment vs no flow assessment or baseline flow findings
Design
Systematic review and meta-analysis of 66 original articles
Authors
Discussion
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Member takes
Implication
TTFM prompts revision in ~4% of CABG patients; confirms assessment utility but heterogeneity leaves diagnostic accuracy open.
Study Design
Type
Meta-Analysis (n=8,943)
Structured PICO
Does intraoperative transit-time flow measurement (TTFM) improve graft assessment and revision rates in patients undergoing CABG?
P
Population
8,943 patients (15,673 grafts) undergoing coronary artery bypass grafting (CABG) from 35 studies
I
Intervention
Intraoperative graft flow assessment by transit-time flow measurement (TTFM)
O
Outcome
Rate of graft revision per patient, rate of graft revision per graft, and rate of graft revision among grafts deemed abnormal based on TTFM parameterssurrogate
Intraoperative TTFM identifies a small but significant proportion of CABG grafts requiring revision, though heterogeneous data limits uniform conclusions on its diagnostic accuracy.
Limitations
- Heterogeneous data made drawing uniform conclusions challenging
- Heterogeneous data
Cite This Study
Thuijs et al. (2019) conducted a meta-analysis in Coronary artery bypass grafting (n=8,943). Transit-time flow measurement (TTFM) was evaluated on Rate of graft revision per patient (95% CI 3.3-5.7). Intraoperative transit-time flow measurement during CABG identified a need for graft revision in 4.3% of patients (95% CI 3.3-5.7%) and 2.0% of grafts.