UNASSIGNED:运输时间流量测量(TTFM)可以在冠状动脉旁路移植术中检测出严重的吻合口狭窄。然而,亚临界狭窄的识别仍然具有挑战性.我们假设舒张阻力指数(DRI),一种新颖的TTFM度量,在评估亚临界狭窄方面比目前可用的TTFM指标更有效。DRI用于测量远端吻合的舒张阻力与收缩阻力的变化。
UNASSIGNED:对35例患者的123例冠状动脉搭桥吻合术进行了前瞻性分析。冠状动脉旁路移植术期间,平均移植物流量(Qmean),搏动指数,并获得舒张期充盈。使用TTFM和动脉压的术中记录计算DRI。术后,吻合狭窄被归类为成功(<50%),亚临界(50%-74%),和临界(≥75%)通过多探测器计算机断层扫描。
未经批准:总共,93(76%),13(10%),17个(14%)吻合成功,次临界,和批判,分别。DRI和舒张充盈可以区分亚临界和成功吻合(分别为P<0.01和<0.01),而Qmean和搏动指数不能(分别为P=.12和.39)。建立受试者工作特征曲线,以评估检测≥50%狭窄的诊断能力。在左前降支移植中(n=55),DRI曲线下面积最高(0.91),其次是舒张充盈(0.87),Qmean(0.74),和搏动指数(0.65)。
UNASSIGNED:DRI和舒张期充盈具有可靠的诊断能力,可在冠状动脉旁路移植术中检测≥50%的狭窄。在左前降支移植中,DRI比其他TTFM指标具有更令人满意的检测能力。
UNASSIGNED: Transit time flow measurement (TTFM) can detect critical anastomotic stenosis during coronary artery bypass grafting. However, the identification of subcritical stenosis remains challenging. We hypothesized that diastolic resistance index (DRI), a novel TTFM metric, is more effective in evaluating subcritical stenosis than the currently available TTFM metrics. DRI is used to measure changes in the diastolic versus systolic resistance of distal anastomosis.
UNASSIGNED: A total of 123 coronary bypass anastomoses in 35 patients were prospectively analyzed. During coronary artery bypass grafting, the mean graft flow (Qmean), pulsatility index, and diastolic filling were obtained. DRI was calculated using the intraoperative recordings of TTFM and arterial pressure. Postoperatively, stenosis of anastomoses was categorized into successful (<50%), subcritical (50%-74%), and critical (≥75%) via multidetector computed tomography scan.
UNASSIGNED: In total, 93 (76%), 13 (10%), and 17 (14%) anastomoses were graded as successful, subcritical, and critical, respectively. DRI and diastolic filling could distinguish subcritical from successful anastomoses (P < .01 and < .01, respectively), whereas Qmean and pulsatility index could not (P = .12 and .39, respectively). The receiver operating characteristic curves were established to evaluate the diagnostic ability for detecting ≥50% stenosis. In left anterior descending artery grafting (n = 55), DRI had the highest area under the curve (0.91), followed by diastolic filling (0.87), Qmean (0.74), and pulsatility index (0.65).
UNASSIGNED: DRI and diastolic filling had a reliable diagnostic ability for detecting ≥50% stenosis during coronary artery bypass grafting. In left anterior descending artery grafting, DRI had a more satisfactory detection capability than other TTFM metrics.