None listed
Conditions
Brief summary
Prospective observational study that is based on the analysis of the flow distribution in arterial composite graft that is used for surgical myocardial revascularization (coronary artery bypass grafting). Composite graft is a bypass configuration in which a free arterial graft is anastomosed to the side of a primary in situ arterial graft that provides the blood supply to the whole conduit. Each of the branches of such composite graft can be anastomosed to a different target coronary artery. According to current knowledge and published studies, it is unclear, whether the flow distribution within the branches of composite graft is even or competitive and whether this is affected by the severity and ratio of stenoses of the target coronary arteries. Our study should provide an answer to two questions: The first is, whether the composite graft can be used in all patients thank to the even distribution of the flow within the branches, or whether there is a competitive flow due to different severity of stenoses of target coronary arteries and if so what degree of such difference or ratio of stenoses is responsible for flow competition. In all patients enrolled into the study we will measure the flow in both branches of the composite graft once the revascularization is complete and then will provide a statistical analysis to find out whether there is any correlation between the ratio of stenoses of the target vessels and the ratio of the flow in the branches of composite graft. The flow will be measured using the transit time flow measurement (TTFM) technology The second question is whether the findings of the flow distribution have any long-term impact on the occurrence of the major adverse cardiac events (MACE) after coronary artery bypass grafting. All patients will be questioned regarding the occurrence of MACEs 6, 12, 24, 36, 48 and 60 months after operation. The obtained data will be then statistically analyzed.
Interventions
The study is based on the analysis of transit time flow measurement of arterial composite graft branches during coronary artery bypass grafting with regards to the severity and ratio of stenoses of native target coronary arteries. The measurement will be performed and recorded immediately after all anastomoses are completed, Medistim MiraQ Cardiac ultrasound device will be used. Even or competitive flow distribution will be evaluated. There will be a second phase of the study - long term follow
The study is based on the analysis of transit time flow measurement of arterial composite graft branches during coronary artery bypass grafting with regards to the severity and ratio of stenoses of native target coronary arteries. The measurement will be performed and recorded immediately after all anastomoses are completed, Medistim MiraQ Cardiac ultrasound device will be used. Even or competitive flow distribution will be evaluated. There will be a second phase of the study - long term follow up of enrolled patients focused on the occurence of major adverse cardiac events. Participants will receive a brief phone call during which they will be asked to self-report major adverse cardiac events, follow up data will be collected at 6, 12, 24, 36, 48, and 60 months post-surgery. In case of death, this will be reported by patient's general practicioner, who will agree with this before the enrollement of patient into the study.
Sponsors
General Universitiy Hospital in Prague
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients with coronary heart disease indicated to coronary artery bypass grafting. Surgeon indicates the use of arterial composite graft to revascularize left anterior descending artery and obtuse marginal artery.
Exclusion criteria
The use of sequential anastomoses.
Outcome results
None listed