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Fırat Üniversitesi Sağlık Bilimleri Tıp Dergisi
2021, Cilt 35, Sayı 1, Sayfa(lar) 001-008
[ Turkish ] [ Tam Metin ] [ PDF ]
Coronary Flow Reserve Assessment Via Echocardiography in Patients with Coronary Bypass Surgery Undergoing LAD-LİMA Long Onlay-Patch Anastomosis without Endarterectomy
1Mersin City Training and Research Hospital, Cardiovascular Surgery Department, Mersin, TURKIYE
2Fırat University, Faculty of Medicine, Cardiovascular Surgery Department, Elazig, TURKIYE
Keywords: Long onlay-patch anastomosis, endarterectomy, coronary flow reserve, coronary bypass, multi-vessel coronary artery disease

Objective: In severe calcified and diffuse coronary lesions, long onlay-patch anastomosis without endarterectomy is another technique to promote augmented blood flow especially to septal perforator branches of left anterior descending artery (LAD). In this study we aimed to demonstrate the efficacy of the long segment onlay-patch anastomosis without endarterectomy via using coronary flow reserve (CFR) measured by doppler echocardiography.

Materiasl and Methods: Fifty six patients who underwent Coronary artery bypass grafting (CABG) onlay-patch anastomosis technique without endarterectomy were evaluated by transthoracic echocardiography for CFR which represents the rates of blood flow both during resting and maximal hyperemia provided by dipyridamole. left anterior descending artery-left internal mammary artery (LAD-LIMA) along the long anastomosis line mid and distal flow patterns were examined, peak systolic and diastolic flow velocities and diastolic velocity time integral were registered.

Results: The mean onlay-patch length was 2.97±0.72 cm. When correlation of changes in coronary flow reserve and other echocardiographic findings were evaluated, there was a statistically significant however, for all patients (normal values: CFR>2, n: 9 and low values: CFR<2, n: 6) inverse correlation between onlay-patch anastomosis length and CFR (2.97±0.72 cm; 2.35±0.56 m/sec; P= 0.008, respectively). Coronary angiography was performed for the one patient with CFR<2. Angiography showed 80% stenosis in the post anastomosis segment.

Conclusion: We explained the reliability of the onlay-patch anastomosis technique without endarterectomy and the usability of CFR measurement with transthoracic echocardiography in the postoperative follow-up of patients who underwent coronary bypass.

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