What question did this study set out to answer?

To assess the predictive value of intraoperative graft flow measurements on short-term in-hospital and medium-term post-discharge clinical outcomes in patients undergoing coronary artery bypass surgery.

April 16, 2008Interactive Cardiovascular and Thoracic SurgeryOpen Access

Intraoperative graft flow measurements during coronary artery bypass surgery predict in-hospital outcomes

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Why the study?

Does abnormal intraoperative graft flow predict adverse in-hospital outcomes in patients undergoing CABG?

Population

985 cardiac surgery patients undergoing coronary artery bypass grafts (CABG) with measured graft flows.

Comparison

Abnormal graft flow measured intraoperatively… vs Normal flow (pulsatility index ≤ 5) in all grafts.

Design

Cohort

Follow-up

mean 1.8 years for survivors to discharge

Authors

CHChristine HermanDalhousie University JSJohn A. SullivanDalhousie University KBKaren J. ButhDalhousie University

Discussion

Member takes

Implication

Abnormal graft flow identifies higher-risk CABG patients; hypothesis-generating for flow-guided strategies pending prospective trials.

Key Points

To assess the predictive value of intraoperative graft flow measurements on short-term in-hospital and medium-term post-discharge clinical outcomes in patients undergoing coronary artery bypass surgery.
Analyzed N=985 cardiac surgery patients with intraoperative transit-time flowmetry recordings obtained using the Medtronic Butterfly Flowmetry system.
Categorized patients into normal flow across all grafts versus abnormal flow in ≥1 graft, defined by a pulsatility index >5.
Evaluated in-hospital adverse cardiac events and tracked discharged survivors across a mean follow-up period of 1.8 years for mortality and cardiac readmissions.
Abnormal graft flow was detected in 19% of patients and independently predicted in-hospital composite adverse cardiac events (31% vs. 17%; P<0.0001; adjusted OR 1.7, 95% CI 1.1–2.7).
Overall in-hospital mortality was 4.7%, with no statistically significant difference between normal and abnormal flow cohorts.
During a mean follow-up of 1.8 years, abnormal intraoperative flow was not an independent predictor of medium-term mortality or cardiac-related hospital readmission.

Structured PICO

Does abnormal intraoperative graft flow predict adverse in-hospital outcomes in patients undergoing CABG?

Population

985 cardiac surgery patients undergoing coronary artery bypass grafts (CABG) with measured graft flows.

Intervention

Abnormal graft flow (pulsatility index > 5 in ≥1 graft) measured intraoperatively using the Medtronic Butterfly Flowmetry system.

Comparator

Normal flow (pulsatility index ≤ 5) in all grafts.

Outcome

In-hospital composite outcome for adverse cardiac events and in-hospital mortality.composite

Abnormal intraoperative graft flow during CABG is independently associated with an increased risk of short-term in-hospital adverse cardiac events.

Cite This Study

Herman et al. (2008) studied this question.

synapsesocial.com/papers/6a8a904ab1e5d05ea8ecac64 https://doi.org/10.1510/icvts.2008.175208

Topics

Women and heart disease

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Intraoperative graft flow measurements during coronary artery bypass surgery predict in-hospital outcomes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Intraoperative graft flow measurements during coronary artery bypass surgery predict in-hospital outcomes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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