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Transit time flow measurement of coronary bypass grafts before and after protamine administration.
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- Author(s): Leviner DB;Leviner DB; von Mücke Similon M; von Mücke Similon M; Rosati CM; Rosati CM; Amabile A; Amabile A; Amabile A; Thuijs DJFM; Thuijs DJFM; Giammarco GD; Giammarco GD; Wendt D; Wendt D; Trachiotis GD; Trachiotis GD; Kieser TM; Kieser TM; Kappetein AP; Kappetein AP; Head SJ; Head SJ; Taggart DP; Taggart DP; Puskas JD; Puskas JD
- Source:
Journal of cardiothoracic surgery [J Cardiothorac Surg] 2021 Jul 09; Vol. 16 (1), pp. 195. Date of Electronic Publication: 2021 Jul 09.- Publication Type:
Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: BioMed Central Country of Publication: England NLM ID: 101265113 Publication Model: Electronic Cited Medium: Internet ISSN: 1749-8090 (Electronic) Linking ISSN: 17498090 NLM ISO Abbreviation: J Cardiothorac Surg Subsets: MEDLINE
- Publication Information: Original Publication: [London] : BioMed Central, 2006-
- Subject Terms:
- Abstract: Background: Intraoperative graft assessment with tools like Transit Time Flow Measurement (TTFM) is imperative for quality control in coronary surgery. We investigated the variation of TTFM parameters before and after protamine administration to identify new benchmark parameters for graft quality assessment.
Methods: The database of the REQUEST ("REgistry for QUality AssESsmenT with Ultrasound Imaging and TTFM in Cardiac Bypass Surgery") study was retrospectively reviewed. A per graft analysis was performed. Only single grafts (i.e., no sequential nor composite grafts) where both pre- and post-protamine TTFM values were recorded with an acoustical coupling index > 30% were included. Grafts with incomplete data and mixed grafts (arterio-venous) were excluded. A second analysis was performed including single grafts only in the same MAP range pre- and post- protamine administration.
Results: After adjusting for MAP, we found a small increase in MGF (29 mL/min to 30 mL/min, p = 0.009) and decrease in PI (2.3 to 2.2, p < 0.001) were observed after the administration of protamine. These changes were especially notable for venous conduits and for CABG procedures performed on-pump.
Conclusion: The small changes in TTFM parameters observed before and after protamine administration seem to be clinically irrelevant, despite being statistically significant in aggregate. Our data do not support a need to perform TTFM measurements both before and after protamine administration. A single TTFM measurement taken either before or after protamine may suffice to achieve reliable data on each graft's performance. Depending on the specific clinical situation and intraoperative changes, more measurements may be informative.
Trial Registration: Clinical Trials Number: NCT02385344 , registered February 17th, 2015.
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- Contributed Indexing: Keywords: Coronary artery bypass grafting; Intraoperative graft flow measurement; Quality control
- Molecular Sequence: ClinicalTrials.gov NCT02385344
- Accession Number: 0 (Heparin Antagonists)
0 (Protamines) - Publication Date: Date Created: 20210710 Date Completed: 20210719 Latest Revision: 20220327
- Publication Date: 20221213
- Accession Number: PMC8268198
- Accession Number: 10.1186/s13019-021-01575-y
- Accession Number: 34243799
- Source:
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