Intraoperative graft flow assessment for myocardial surgical revascularization

Abstract

Intraoperative graft assessment should be considered a vital step during surgical myocardial revascularization that is performed following completion of grafting. It provides the surgeon a tool to assess graft flow and quality. Hence, it reduces graft failure rates related to avoidable or correctable technical errors, leading to improved early and late postoperative outcomes. Additionally, modern intraoperative functional coronary flow tests facilitate decision-making regarding the indication for revascularization of a particular vessel based on the functional significance and degree of ischemia induced by a lesion in that coronary artery. A wider implementation of intraoperative graft assessment modalities has the potential to improve graft patency and outcomes following myocardial revascularization. However, further research in the field is required before it becomes the standard of care during coronary artery bypass graft surgery. This article provides a general review of strategies and methods of coronary artery graft flow assessment, focusing on their availability and feasibility as well as strengths and limitations.

Keywords

CABG / intraoperative graft flow assessment / transit-time flow measurement / high-resolution epicardial ultrasonography / fractional flow reserve

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