Immediate Graft Flow Outcomes of 8-0 Prolene Sutures in Off-pump Coronary Artery Bypass Grafting_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANGFan , YUYang , LIJing-xing , LIHai-tao , GAOMing-xin , BAIChen ,  GUCheng-xiong

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P. R. China;

Corresponding?author：

GUCheng-xiong, Email: anzhengu@sina.com

Keywords：

Off-pump coronary artery bypass grafting; 8-0 Prolene suture; Transit time flow measurement; Graft patency

DOI：

10.7507/1007-4848.20140171

Video：

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Objective To evaluate immediate outcomes of 8-0 Prolene sutures for distal anastomosis during off-pump coronary artery bypass grafting (OPCAB). Methods A total of 101 patients who underwent OPCAB in Department of Cardiac Surgery of Beijing Anzhen Hospital in 2010 and 2012 respectively were enrolled in this study. There were 87 male and 14 female patients with their age of 46-82 (61.35±8.24)years. All the 36 patients in 2010 received 7-0 Prolene sutures for distal anastomosis, and the 65 patients in 2012 received 8-0 Prolene sutures for distal anastomosis. After anastomosis, transit time flow measurement was used to measure blood flow indexes of graft vessels[left internal mammary artery (LIMA)and saphenous vein (SV)] including blood flow volume (BFV), pulsatility index (PI)and diastolic filling fraction (DF), which were compared between patients receiving 7-0 and 8-0 Prolene sutures. Results BFV of LIMA grafts with 8-0 Prolene sutures (n=44)was significantly larger than that with 7-0 Prolene sutures (n=30)[ (33.70±21.13)ml/min vs. (27.50±17.34)ml/min, P=0.032], while PI of LIMA grafts with 8-0 Prolene sutures was significantly smaller than that with 7-0 Prolene sutures (2.15±0.69 vs. 2.58±1.01, P=0.047). BFV and PI of SV grafts with 8-0 Prolene sutures (n=21) were not statistically different from those with 7-0 Prolene sutures (n=6)[ (34.19±16.00)ml/min vs. (29.00±15.48)ml/min, P > 0.05;2.07±0.53 vs. 1.95±0.55, P > 0.05]. DF of all the grafts was greater than 50%, and there was no statistical difference in DF between the 2 groups (P > 0.05). Conclusion 8-0 Prolene sutures for LIMA-to-left anterior descending artery can improve BFV and decrease PI of LIMA grafts, which reflects better immediate graft patency of the distal anastomosis and helps improve surgical success rate and long-term prognosis.

Citation： ZHANGFan, YUYang, LIJing-xing, LIHai-tao, GAOMing-xin, BAIChen, GUCheng-xiong. Immediate Graft Flow Outcomes of 8-0 Prolene Sutures in Off-pump Coronary Artery Bypass Grafting. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(5): 599-602. doi: 10.7507/1007-4848.20140171 Copy

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17.	Podesser BK,R?dler S,Hahn R,et al. Mid-term follow up of mitral valve reconstruction due to active infective endocarditis. J Heart Valve Dis,2000,9(3):335-340.
18.	Eishi K,Kawazoe K,Kuriyama Y,et al. Surgical management of infective endocarditis associated with cerebral complications. J Thorac Cardiovasc Surg,1995,110(6):1745-1755.
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20.	Ruttmann E,Legit C,Poelzl G,et al. Mitral valve repair provides improved outcome over replacement in active infective endocarditis. J Thorac Cardiovasc Surg,2005,130(3):765-771.
21.	Feringa HH,Bax JJ,Klein P,et al. Outcome after mitral valve repair for acute and healed infective endocarditis. Eur J Cardiothorac Surg,2006,29(3):367-373.
22.	Shang E,Forrest GN,Chizmar T,et al. Mitral valve infective endocar-ditis:benefit of early operation and aggressive use of repair. Ann Thorac Surg,2009,87(6):1728-1734.
23.	Jung SH,Je HG,Choo SJ,et al. Surgical results of active infective native mitral valve endocarditis:repair versus replacement. Eur J Cardiothorac Surg,2011,40(4):834-839.
24.	Musci M,Hübler M,Amiri A,et al. Repair for active infective atrioventricular valve endocarditis:23-year single center experience. Clin Res Cardiol,2011,100(11):993-1002.
25.	黃信生,謝進生,尤斌,等. 瓣膜成形術治療原發性感染性心內膜炎二尖瓣關閉不全. 中華外科雜志,2009,47(16):1236-1238.
26.	高峰,孟旭. 二尖瓣成形術治療感染性心內膜炎二尖瓣關閉不全. 中華胸心血管外科雜志,2011,27(6):357-360.

1. Evans CF,Gammie JS. Surgical management of mitral valve infective endocarditis. Semin Thorac Cardiovasc Surg,2011,23(3):232-240.
2. 張爾永,石應康,程述森,等. 原發性感染性心內膜炎瓣膜損害的外科治療. 中國胸心血管外科臨床雜志,1999,6(2):22-24.
3. 楊新偉,王志農,徐志云,等. 二尖瓣脫垂合并感染性心內膜炎的手術治療. 第二軍醫大學學報,2009,30(2):133-136.
4. Moreillon P,Que YA. Infective endocarditis. Lancet,2004,363(9403):139-149.
5. López J,Revilla A,Vilacosta I,et al. Age-dependent profile of left-sided infective endocarditis:a 3-center experience. Circulation,2010,121(7):892-897.
6. Hasbun R,Vikram HR,Barakat LA,et al. Complicated left-sided native valve endocarditis in adults:risk classification for mortality. JAMA,2003,289(15):1933-1940.
7. Chambers HF. Transesophageal echocardiography in endocarditis. Chest,1994,105(2):333-334.
8. 8朱曉東,張寶仁,主編.心臟外科學. 北京:人民衛生出版社,2007. 800-801.
9. Shimokawa T,Kasegawa H,Matsuyama S,et al. Long-Term outcome of mitral valve repair for infective endocarditis. Ann Thorac Surg,2009,88(3):733-739.
10. Iung B,Rousseau-Paziaud J,Cormier B,et al. Contemporary results of mitral valve repair for infective endocarditis. J Am Coll Cardiol,2004,43(3):386-392.
11. Zegdi R,Debièche M,Latrémouille C,et al. Long-term results of mitral valve repair in active endocarditis. Circulation,2005,111(19):2532-2536.
12. Yamaguchi H,Eishi K,Yamachika S,et al. Mitral valve repair in patients with infective endocarditis. Circ J,2006,70(2):179-183.
13. de Kerchove L,Vanoverschelde JL,Poncelet A,et al. Reconstructive surgery in active mitral valve endocarditis:feasibility,safety and durability. Eur J Cardiothorac Surg,2007,31(4):592-599.
14. Omoto T,Tedoriya T,Oi M,et al. Significance of mitral valve repair for active-phase infective endocarditis. Asian Cardiovasc Thorac Ann,2011,19(2):149-153.
15. Aragam JR,Weyman AE,chief Editor. Echocardiographic findings in infective endocarditis. In:Weyman AE,ed. Principles and Practice of Echocardiography. 2nd ed. Philadelphia:Lea & Fabiger,1994. 1178-1197.
16. 符竣,陶涼,陳緒發,等. 感染性心內膜炎外科治療時機. 中國胸心血管外科臨床雜志,2003,10(2):147-148.
17. Podesser BK,R?dler S,Hahn R,et al. Mid-term follow up of mitral valve reconstruction due to active infective endocarditis. J Heart Valve Dis,2000,9(3):335-340.
18. Eishi K,Kawazoe K,Kuriyama Y,et al. Surgical management of infective endocarditis associated with cerebral complications. J Thorac Cardiovasc Surg,1995,110(6):1745-1755.
19. Omoto T,Ohno M,Fukuzumi M,et al. Mitral valve repair for infective endocarditis. Gen Thorac Cardiovasc Surg,2008,56(6):277-280.
20. Ruttmann E,Legit C,Poelzl G,et al. Mitral valve repair provides improved outcome over replacement in active infective endocarditis. J Thorac Cardiovasc Surg,2005,130(3):765-771.
21. Feringa HH,Bax JJ,Klein P,et al. Outcome after mitral valve repair for acute and healed infective endocarditis. Eur J Cardiothorac Surg,2006,29(3):367-373.
22. Shang E,Forrest GN,Chizmar T,et al. Mitral valve infective endocar-ditis:benefit of early operation and aggressive use of repair. Ann Thorac Surg,2009,87(6):1728-1734.
23. Jung SH,Je HG,Choo SJ,et al. Surgical results of active infective native mitral valve endocarditis:repair versus replacement. Eur J Cardiothorac Surg,2011,40(4):834-839.
24. Musci M,Hübler M,Amiri A,et al. Repair for active infective atrioventricular valve endocarditis:23-year single center experience. Clin Res Cardiol,2011,100(11):993-1002.
25. 黃信生,謝進生,尤斌,等. 瓣膜成形術治療原發性感染性心內膜炎二尖瓣關閉不全. 中華外科雜志,2009,47(16):1236-1238.
26. 高峰,孟旭. 二尖瓣成形術治療感染性心內膜炎二尖瓣關閉不全. 中華胸心血管外科雜志,2011,27(6):357-360.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Immediate Graft Flow Outcomes of 8-0 Prolene Sutures in Off-pump Coronary Artery Bypass Grafting

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