Vrednost meritev TIMI frame count in zozitve vencne arterije za napoved pretoka skozi obvod vencne arterije

Abstract

Objectives: The aim of this retrospective study was to evaluate the prognostic value of corrected thrombolysis in myocardial infarction frame count (cTFC) measurements and dierent cuto values of the degree of proximal coronary artery stenosis in a series of patients who had undergone elective isolated coronary artery bypass surgery.

Methods: A retrospective analysis of 98 patients who had elective isolated coronary artery bypass surgery performed at our institution between January 2008 and March 2009 was made. Preoperatively, all patients had undergone angiography. The degree of epicardial coronary stenosis was estimated visually by the cardiologist, and cTFC of the target coronary arteries was obtained from standard projections on preoperative coronary angiograms with frame rate of 12.5 frames/s. All bypass gras were evaluated by intraoperative transit time ow measurement (TTFM).

Results: All bypass gras were divided according to the results into four nearly equally sized groups using cTFC and percentage of proximal coronary artery stenosis. The cut-o values for both cTFC and percentage of stenosis were their median values (cTFC14, percentage of stenosis80 %). Bypass gras in the four groups showed signicant dierences in mean ow.

In group 1 (high percent stenosis and high cTFC) mean bypass gra ow was 38.3 20.3 ml/min, in group 2 (low percent stenosis and high cTFC) mean bypass gra ow was 29.0 15.1 ml/min, in group 3 (high percent stenosis and low cTFC) mean bypass gra ow was 48.2 26.3 ml/min, and in group 4 (low percent stenosis and low cTFC) mean bypass gra ow was 35.3 14.8 ml/min. Dierences between individual groups were signicant for all combinations except when comparing group 1 with group 4.

Conclusion: Combining the data obtained from coronary angiography and TFC has shown to have a good predictive value for postoperative coronary bypass gra ow, and could thus help surgeons in making choice of target vessels for bypass surgery or help them decide whather revision of a bypass gra would be benecial.