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Transit Time Flow Measurement in Coronary Surgery

Not yet recruiting
Conditions
Coronary Artery Disease
Coronary Bypass Graft Stenosis
Coronary Stenosis
Registration Number
NCT06471062
Lead Sponsor
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Brief Summary

Transit-time flowmetry (TTFM) allows grafts quality control during coronary artery bypass surgery by measuring the flow volume through them.

To date, many studies have deeply studied the predictive role on the graft outcomes of the various flowmetry-derived parameters. One of the least investigated aspects, however, is the mutual influence that two newly realized grafts can have. This possibility would be related to the presence of a more or less developed collateral circulation between the bypassed territories.

The purpose of this study is to assess whether a graft for a territory different than that provided by the left anterior descending artery (LAD) may affect the functionality (measured through flowmetry) of the left internal mammary artery - LAD graft.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
135
Inclusion Criteria
  • age > 18 years;
  • informed consent acquired and registered;
  • patients who undergo coronary artery bypass grafting (with or without cardiopulmonary bypass);
  • patients with stable angina, unstable angina or acute coronary syndrome without elevation of the ST tract (NSTEMI)
Exclusion Criteria
  • patients unable to give informed consent;
  • patients undergoing emergency surgery;
  • patients in unstable haemodynamic conditions or in need of pharmacological or mechanical support;
  • patients undergoing combined surgery;
  • patients undergoing single aortocoronary bypass surgery

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
LIMA>LAD Pulsatility index (PI) modificationDuring the surgery, out of cardiopulmonary bypass

The primary aim of this study is to assess whether a graft for a non-LAD coronary target modifies the performance (measured by flowmetry) of the flow in the LIMA\>LAD graft.

PI is expressed by the ratio of the flow volume amplitude and mean flow volume, both quantified by a flowmeter (ml/min / ml/min). An ideal value would be \< 3

Secondary Outcome Measures
NameTimeMethod
LIMA>LAD Diastolic filling (%DF) changeDuring surgery,before and after transient occlusion of the other grafts for non-LAD coronary targets.

under rest conditions and after pharmacological stress. The unit of measure will be the ratio between two parameters expressed by ml/min.

variation of Diastolic filling (%DF) on the right coronaryDuring surgery,before and after transient occlusion of the other grafts for non-LAD coronary targets.

depending on its dominance or hyperdominance. The unit of measure will be the ratio between two parameters expressed by ml/min. DF% is accepted around 50%.

LIMA>LAD % Backward flow (BF) changeDuring surgery, before and after transient occlusion of the other grafts for non-LAD coronary targets.

under rest conditions and after pharmacological stress. The unit of measure will be the ratio between two parameters expressed by ml/min. The identified cut-off is 3% of the total flow.

LIMA>LAD mean flow changeDuring surgery, before and after transient occlusion of the other grafts for non-LAD coronary targets

under rest conditions and after pharmacological stress. The unit of measure will be ml/min. The average flow should be above 20 ml/min.

mean flow, Pulsatility Index, Diastolic filling (%DF) and Diastolic filling (%DF) in the non-LAD graftsDuring surgery, before and after transient occlusion of the LIMA>LAD graft

under rest conditions and after pharmacological stress. The meaf low will be measured in "ml/min". The others will be expressed by the ratio between two parameters expressed by ml/min.

Trial Locations

Locations (1)

Fondazione Policlinico Gemelli IRCCS

🇮🇹

Roma, Italy

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